-
Pediatric Neurology 1988Four children who exhibited akinetic mutism during the course of their neurologic diseases were treated with bromocriptine. Reversal of the akinetic mute states was...
Four children who exhibited akinetic mutism during the course of their neurologic diseases were treated with bromocriptine. Reversal of the akinetic mute states was evident in all patients. Pathways of the dopaminergic neurons are reviewed and a clinically useful mechanism which causes akinetic mutism is postulated.
Topics: Adolescent; Akinetic Mutism; Brain Diseases; Bromocriptine; Dopamine; Female; Frontal Lobe; Humans; Infant; Male; Radiography
PubMed: 3242525
DOI: 10.1016/0887-8994(88)90036-7 -
European Journal of Neurology Jul 2011It is not known whether the clinical course of Japanese sporadic Creutzfeldt-Jakob disease (sCJD) cases differs from that of Caucasian sCJD cases.
BACKGROUND
It is not known whether the clinical course of Japanese sporadic Creutzfeldt-Jakob disease (sCJD) cases differs from that of Caucasian sCJD cases.
PATIENTS AND METHODS
To investigate the clinical course of Japanese sCJD, clinical findings from 29 patients with Japanese MM1-type sCJD were retrospectively evaluated and compared to Caucasian sCJD findings.
RESULTS
Survival of Japanese MM1-type sCJD up to the time of akinetic mutism state is similar to that of Caucasian subjects. However, the total disease duration of Japanese patients was approximately three times longer.
CONCLUSIONS
The present observations indicate that Japanese sCJD cases generally show a longer disease duration because of the longer survival period after reaching the akinetic mutism state.
Topics: Age of Onset; Aged; Aged, 80 and over; Akinetic Mutism; Asian People; Creutzfeldt-Jakob Syndrome; Disease Progression; Female; Humans; Male; Middle Aged; Retrospective Studies; Time; White People
PubMed: 20722706
DOI: 10.1111/j.1468-1331.2010.03185.x -
Przeglad Lekarski 2013The toxicity of xenobiotics can result inrare disorders of consciousness, such as akinetic mutism and somnambulism as well as syndromes mimicking consciousness... (Review)
Review
The toxicity of xenobiotics can result inrare disorders of consciousness, such as akinetic mutism and somnambulism as well as syndromes mimicking consciousness disturbances, such as locked-in syndrome and psychogenic coma. Akinetic mutism is a condition characterized by a lack of spontaneous movements and little or no vocalization. Somnambulism include performing of complex motor activity in an automatic manner during deep sleep, without any awareness of its execution. The locked-in syndrome is a state with quadriplegia coexisting with cranial nerves palsies and mutism, but with fully preserved consciousness. Psychogenic coma is a condition in which the patient has preserved level of consciousness and awareness, but does not communicate with theenvironment and does not exhibit the external manifestations of consciousness. This paper presents the etiology, clinical characteristics, as well as diagnostic and therapeutic issues for the above syndromes.
Topics: Akinetic Mutism; Coma; Diagnosis, Differential; Humans; Quadriplegia; Somnambulism; Xenobiotics
PubMed: 24466703
DOI: No ID Found -
Journal of Endocrinological... Mar 2006Neuropsychiatric changes during exogenous corticosteroid administration are well-recognized. However, reports of neuropsychiatric reactions to corticosteroid replacement...
Neuropsychiatric changes during exogenous corticosteroid administration are well-recognized. However, reports of neuropsychiatric reactions to corticosteroid replacement for Addison's disease are distinctively rare. We report on a patient with primary adrenocortical insufficiency, initially presenting with depressive symptoms, who developed akinetic mutism followed by acute manic illness shortly after the initiation of steroid replacement. Both disorders occurred with physiological doses of hydrocortisone and resolved spontaneously. The pathogenesis of the above neuropsychiatric reactions is discussed in the context of glucocorticoid receptor-related brain effects of glucocorticoids. In addition, this report points to the need for accurate psychiatric assessment of patients with Addison's disease upon introduction of replacement therapy.
Topics: Addison Disease; Akinetic Mutism; Bipolar Disorder; Electroencephalography; Hormone Replacement Therapy; Humans; Hydrocortisone; Male; Middle Aged
PubMed: 16682841
DOI: 10.1007/BF03345550 -
Surgical Neurology International 2023Pituitary apoplexy is associated with stroke, head injury, and brain tumors. Still, its presentation due to the ruptured aneurysm is rare and its presentation with...
BACKGOUND
Pituitary apoplexy is associated with stroke, head injury, and brain tumors. Still, its presentation due to the ruptured aneurysm is rare and its presentation with akinetic mutism has not been reported.
CASE DESCRIPTION
The patient in the present study is 21-year-old female who presented in our emergency department in an altered sensorium with Glasgow comma score (GCS) E2V1M1. She was intubated and resuscitated. Routine blood investigations, lipid profile, and hormonal studies were normal. Initial noncontrast computed tomography (NCCT) head revealed subarachnoid hemorrhage in the interhemispheric fissure and evidence of bleeding in the pituitary gland. Magnetic resonance imaging (MRI) brain was soon done, which showed an infarct and hemorrhage in the pituitary gland; there was an evidence of an infarct in the bilateral medial frontal gyrus, basal ganglia, and supplementary motor area. MR arteriography revealed an aneurysm at the left A1-anterior communicating artery (Acom) junction directed superomedially with diffuse spasm in a bilateral anterior cerebral artery. Pterional craniotomy was done with clipping of the aneurysm and evacuation of blood clots from the interhemispheric fissure and pituitary gland. Histopathology features suggestive of the non-functioning pituitary tumor with interspersed hemorrhagic necrosis. Intraarterial vasodilation with microcatheter injection was given, but vasospasm did not improve. Postoperatively, Levodopa was started. She used to track objects in front of her eye and started nodding her head in "yes and no fashion," with power in limbs improved to 3/5 at 6 months of follow-up.
CONCLUSION
Pituitary apoplexy with ruptured A1-Acom junction aneurysm with nonfunctioning pituitary macroadenoma is rare, and its presentation with akinetic mutism has not been reported. As there is scarce literature suggesting an association between pituitary apoplexy and ruptured aneurysm, it is challenging to comment regarding its pathogenesis. Although akinetic mutism generally has a poor prognosis, it may respond to Levodopa with a better outcome.
PubMed: 36751455
DOI: 10.25259/SNI_942_2022 -
Singapore Medical Journal May 2007We describe a 72-year-old man who developed akinetic mutism following a cerebrovascular accident involving his right internal watershed area and responded well to...
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. We discuss this rare condition and the unusual unilateral location of the lesion.
Topics: Aged; Akinetic Mutism; Brain; Cerebral Infarction; Humans; Magnetic Resonance Imaging; Male
PubMed: 17453106
DOI: No ID Found -
Acta Neurologica Scandinavica Dec 1998To report 3 new cases of akinetic mutism, a clinical syndrome defined by silent immobility with preserved visual alertness not accountable by lesion of the areas and/or...
OBJECTIVES
To report 3 new cases of akinetic mutism, a clinical syndrome defined by silent immobility with preserved visual alertness not accountable by lesion of the areas and/or effector pathways of speech and voluntary movements.
MATERIAL AND METHODS
Anatomopathological studies were performed in Cases 1 and 2; clinical follow-up, EEG, angiography and CT scans in Case 3.
RESULTS
Case 1: Bipallidal necrosis; Case 2: Left pallidal necrosis with right frontoparietal cortico-subcortical infarction; Case 3: Striato-capsular infarction on the left side, involving the caudate nucleus and the anterior arm of the internal capsule, together with obstructive hydrocephalus.
CONCLUSION
The roles of both globus pallidus and prefrontostriatal circuits in the onset of voluntary movements are discussed.
Topics: Adult; Akinetic Mutism; Cerebral Cortex; Fatal Outcome; Female; Globus Pallidus; Humans; Male; Middle Aged; Tomography, X-Ray Computed
PubMed: 9875624
DOI: 10.1111/j.1600-0404.1998.tb07327.x -
The American Journal of Psychiatry Jan 1990This paper discusses the definition of apathy, reviews its differential diagnosis, and proposes a classification for the conditions that may produce it. Apathy is... (Review)
Review
This paper discusses the definition of apathy, reviews its differential diagnosis, and proposes a classification for the conditions that may produce it. Apathy is defined as diminished motivation not attributable to diminished level of consciousness, cognitive impairment, or emotional distress. In its differential diagnosis, abulia, akinesia and akinetic mutism, depression, dementia, delirium, despair, and demoralization must be ruled out. Classification of apathy is organized in terms of its adaptive and functional consequences, its relationship to personality or to sociocultural or environmental events, and its association with psychiatric, neurological, and medical disorders. An approach to assessment and treatment is proposed.
Topics: Akinetic Mutism; Basal Ganglia Diseases; Delirium; Dementia; Depressive Disorder; Diagnosis, Differential; Emotions; Humans; Mood Disorders; Motivation; Stress, Psychological
PubMed: 2403472
DOI: 10.1176/ajp.147.1.22 -
Shinkei Kenkyu No Shimpo. Advances in... Apr 1971
Review
Topics: Adult; Akinetic Mutism; Autopsy; Brain Diseases; Cerebral Cortex; Cerebral Palsy; Child, Preschool; Cognition Disorders; Diencephalon; Female; Hepatic Encephalopathy; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intellectual Disability; Liver; Liver Diseases; Male; Mesencephalon; Spinal Cord Diseases; Unconsciousness
PubMed: 4933844
DOI: No ID Found -
Journal of the Neurological Sciences Feb 1999A 54-year-old man developed somnolent akinetic mutism and acute mixed transcortical aphasia following a left thalamo-mesencephalic infarction. He also exhibited...
A 54-year-old man developed somnolent akinetic mutism and acute mixed transcortical aphasia following a left thalamo-mesencephalic infarction. He also exhibited behavioural changes, namely apathy, slowness, lack of spontaneity, disinhibition, perseveration, gait apraxia and incontinence consistent with frontal lobe dysfunction. Presumably the akinetic mutism and language dysfunction were due to the thalamic stroke. All the manifestations could be related to interruption of the frontal-subcortical circuitry.
Topics: Affect; Aphasia; Cerebral Infarction; Frontal Lobe; Gait; Humans; Male; Mesencephalon; Middle Aged; Mutism; Radiography; Thalamus
PubMed: 10223414
DOI: 10.1016/s0022-510x(98)00329-3