This type of mutism is caused by bilateral damage to the frontal lobe area of the brain which is responsible for arousal and motivation. Theyll track motion with their eyes, and change position occasionally, but nothing more. Akinetic mutism following stroke request pdf researchgate. Akinetic mutism article about akinetic mutism by the free. Akinetic mutism after right internal watershed infarction lim y c, ding c s l, kong k h abstract we describe a 72 year old man who developed akinetic mutism following a cerebrovascular accident involving his right internal watershed area and responded well to dopaminergic agonists. Akinetic mutism is characterized by an individuals inability to move or speak. However, their eyes may follow their observer or be diverted by sound.
They describe the clinical features as mutism accompanied with limited movement in patients who have their eyes open, will track visual stimuli, and withdraw from painful stimuli. Akinetic mutism is a variety of stupor in which the patient is unable to talk or carry out purposeful behaviour but may lie with eyes open, seemingly unaware of what is going on around him. A b c 1 periodic sharp 1 myoclonus wave complexes on routine 2 visual or eeg during an investigations that cerebellar signs illness of any do not indicate an duration alternative 3 pyramidal diagnosis extrapyramidal signs 2 positive 1433 csf assay in 4 akinetic mutism patients with a disease duration of less than 2 years 3 mri high signal abnormalities in caudate nucleus and. Four case studies are presented describing the successful treatment of abulia at a lesser severity than akinetic mutism with bromocriptine. Brust, angel chamorro, in stroke sixth edition, 2016. The aim of this study was to delimit the symptom of akinetic mutism in patients with creutzfeldtjakob disease from the complex of symptoms of an apallic syndrome and to assign it to the individual forms. The child who is born with normal hearing and then loses it may lose part or all of the power of speech through loss of contact with the speech of. Akinetic mutism akinetic mutism caused by tumors, tbi, anoxia, encephalitis, etc total absence of spontaneous behavior and speech, however can visually track objects abulia. More detailed information about the symptoms, causes, and treatments of akinetic mutism is available below. There are 0 terms under the parent term akinetic mutism in the icd10cm alphabetical index.
Request pdf akinetic mutism following stroke this is an appraisal of the. Akinetic mutism is an unusual mental state in which the patient is mute, generally unresponsive and unwilling to perform even simple motor activity. Akinetic mutism case reports and aetiological considerations. Muteness results in the complete absence or at least a significant loss of verbal communication. Following a description about the characteristics of akinetic mutism am.
Akinetic mutism is described in various clinical presentations but typically is defined as a state wherein the patient appears. Unique presentation of akinetic mutism and coexisting thyroid. Akinetic mutism is described in various clinical presentations but typically is defined as a state wherein the patient appears awake but does not move or speak. Akinetic seizure definition of akinetic seizure by medical. Akinetic mutism could be explained by damage to the frontal lobe and or. This is an appraisal of the varied clinical presentation and the neural substrate for akinetic mutism following stroke. It has been described in a number of neurological conditions including trauma, malignancy and cerebral ischaemia. However, in this case, the affected individual is alert and heshe may make active eye movements in response to a person or sound. However, alertness, visual fixation, motor and sensory functions and some fundamental cognitive abilities are preserved1,2. After 6 weeks of severe akinetic mutism refractory to one ect treatment and trials of steroids and stimulants, the patient recovered spontaneously over a 2month period. Reversible akinetic mutism after aneurysmal subarachnoid. Neth j crit care volume 24 no 3 may 2016 29 netherlands journal of critical care submitted october 2015.
Akinetic mutism following prefrontal injury by an electrical grinder a. Akinetic mutism is not a state like paralysis, in akinetic mutism it all depends upon the patients will to move and speak. It is charted under both psychiatric and neurological diseases. Before people started playing with predictors, akinetic mutism was very rare, a result of damage to the anterior cingulate region of the. Akinetic mutism and cognitiveaffective syndrome caused by. Abulia refers to an impairment of will, or the inability to initiate behaviour and action.
Akinetic mutism is often the result of severe frontal lobe injury in which the pattern of inhibitory control is one of increasing passivity and gradually decreasing speech and motion. In which patient lack some motor activities like movement of facial muscles to show facial expressions and gestures. Apr 07, 20 psychology definition of akinetic mutism. Slideshow 17 everyday ways to ease depression see slideshow. Results for akinetic mutism 1 6 of 6 sorted by relevance date click export csv or ris to download the entire page or use the checkboxes to select a subset of records to download export csv export ris 10 per page 50 per page 100 per page 250 per page. Jul 28, 2016 akinetic mutism after subarachnoid haemorrhage 1. Treating organic abulia with bromocriptine and lisuride. Schoonman1 departments of 1 neurology, 2 intensive care. We report on two cases of transient akinetic mutism after massive subarachnoid haemorrhage due to the rupture of an intracranial aneurysm of the anterior cerebral artery aca. Akinetic mutism is a medical term describing patients tending neither to move nor speak. Mutism in the older population in not uncommon and may have one of many causes, including severe depression, lockedin syndrome, and persistent vegetative state. Stephen ashwal, in swaimans pediatric neurology sixth edition, 2017. The end state is akinetic mutism, a kind of waking coma.
Akinetic mutism as a classification criterion for the. Akinetic mutism was first described in 1941 as a mental state where patients lack the ability to move or speak. Kim ms, rhee jj, lee sj, kwon sj, lee ch 2007 akinetic mutism responsive to bromocriptine following subdural hematoma evacuation in a patient with hydrocephalus. Akinetic mutism has a number of causes with varied pathology and is characterized by a marked reduction in motor function, including facial expression, gestures. Pdf persistent vegetative state, akinetic mutism and consciousness neil levy and will davies academia. Akinetic mutism can be caused by a variety of things. A patient with akinetic mutism shows symptoms that are similar to other recognized conditions, such as catatonia in psychiatric patients and lockedin state in paralysis patients, but it is a distinct medical condition. Treatment of akinetic mutism with intramuscular olanzapine. A syndrome characterized by a silent and inert state without voluntary motor activity despite preserved sensorimotor pathways and vigilance.
Keywords akinetic mutism, abulia, subarachnoid haemorrhage, cingulate cortex abstract akinetic mutism is a rare neurological condition characterised by the lack of verbal and motor output in the presence of preserved alertness. The full syndrome of akinetic mutism or abulia has thus not been produced in animals by experimental cingulectomy or in humans by surgical cingulectomy, and even bilateral aca ligation in humans has on occasion failed to cause the syndrome. The anterior cingulate cortex acchas been identified as part of a supervisoryattentional network for selecting alternativemotor programs in response to topdown corticalprocessing, particularly in situationsinvolving conflicting cognitive tasks. Lack of initiative in thought, speech, physical action and affective emotion reluctance to perform simple motor activities, however has ability to do so. It has been reported in children with brain tumors, bacterial and viral cns infections, hydrocephalus, and occasionally as a postoperative phenomenon. We discuss this rare condition and the unusual unilateral.
Clonic perseveration is an unusual but well recognised sign which may be mistaken for seizures. It is a term that is used medically and is believed to be associated with the mental state of an affected individual. Selective mutism for writers february 12, 2018 tamar sloan character development, psychological disorders 4 comments this weeks blog post was requested by a reader, one of my favourite ways to prompt an article. Mutism is also found in patients suffering from schizophrenia and hysteria. Akinetic mutism after internal watershed infarction. Episodically remitting akinetic mutism following subarachnoid hemorrhage article pdf available in journal of neuropsychiatry 111. Akinetic mutism related symptoms are more likely resemble the symptoms of shock. The ability to speak disappears suddenly and returns just as unexpectedly. Mutism article about mutism by the free dictionary. Akinetic mutismnot coma age and ageing oxford academic. A spectrum of motivational impairment has abulia at one end and akinetic mutism at the other.
Bilateral paramedian thalamic infarction is an uncommon but recognised cause of akinetic mutism and clonic perseveration. In the two cases, vasospasm could not be demonstrated by imaging studies throughout the clinical course. Akinetic mutism definition, a state of apparent alertness with normal eye movements but no speech or other voluntary motion, usually due to a stroke. Patients lack most motor functions such as speech, facial expressions, and gestures, but demonstrate apparent alertness. We declare that we participated in the preparation and writing of this manuscript and that we have seen and approved the final version. Pdf episodically remitting akinetic mutism following. Request pdf akinetic mutism following stroke this is an appraisal of the varied clinical presentation and the neural substrate for akinetic mutism following stroke. Akinetic mutism definition of akinetic mutism by medical. Akinetic mutism abulia akinetic mutism is a state of limited responsiveness to the environment in the absence of gross alteration of sensorimotor mechanisms operating at a more peripheral level. Akinetic mutism has been anatomically divided into two formsthe mesencephalic form and the frontal form. Muteness or mutism is medically defined as a speech affliction wherein the patient is unable to have the normal capacity to speak.
Differentiating akinetic mutism from coma is difficult. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Pdf persistent vegetative state, akinetic mutism and. Akinetic mutism related to mutism caused by brain injury, many of people who suffer from this type of mutism are completely unable to move akinesia and are unable to produce language because of the disorder. It often occurs after brain injury or as a symptom of other diseases. Among the classification criteria for the diagnosis of creutzfeldtjakob disease, akinetic mutism is described as a symptom which helps to establish the diagnosis as possible or probable. The ability to move remains, but the motivation is gone. The anterior cingulate cortex, akinetic mutism, and human. Accepted march 2016 c a s e r e p o r t lack of motivation. Akinetic mutism is a rare condition consisting of pathologically slowed or nearly absent bodily movement, accompanied by a similar loss of speech. Pdf akinetic mutism following stroke nages nagaratnam. We describe a case of akinetic mutism mistaken as coma. Akinetic mutism medigoo health medical tests medical.
Hysterical mutism is usually complete, that is, the patient does not utter a single word. Aan members 800 8791960 or 612 9286000 international nonaan member subscribers 800 6383030 or 301 2232300 option 3, select 1 international. Akinetic mutism am is defined as a form of stupor, characterised by severe apathy. Akinetic mutism definition of akinetic mutism by the free. Bilateral lesions to the acc may be causallyassociated with akinetic mutism, where patientsare unable to voluntarily initiate responses. Berger l, gauthier s, leblanc r 1985 akinetic mutism and parkinsonism associated with obstructive hydrocephalus. The icd10cm alphabetical index is designed to allow medical coders to look up various medical terms and connect them with the appropriate icd codes. There are reports of successful treatment of akinetic mutism, the most severe form of abulia, with bromocriptine. Following the landmark case report of cairns et al. Akinetic mutism definition, symptoms, causes, treatment. A state in which a person is unable to speak mute or move akinetic. Akinetic mutism symptoms, diagnosis, treatments and causes. A 42yearold man with left posterior inferior cerebellar artery pica infarction presented with akinetic mutism and cognitive impairment. Pdf akinetic mutism as a classification criterion for the.
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