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Akinetic Mutism
Published in Alexander R. Toftness, Incredible Consequences of Brain Injury, 2023
There are many different possible causes of akinetic mutism, including damage to the frontal lobes, brain stem, and/or thalamus regions, which can occur due to any brain-damaging event such as stroke, tumor, carbon monoxide poisoning, Creutzfeldt-Jakob disease (see Creutzfeldt-Jakob Disease), and many others (Herklots et al., 2016). In the brain, there are loops of communication lines between cells that, by sending signals back and forth to each other, can express a person's motivations to do something through taking action and actually doing that thing. The parts of your brain responsible for generating motivation are mostly located in the frontal lobe, but motivation involves many other brain regions as well (Arnts et al., 2020).
Degenerative Diseases of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
James A. Mastrianni, Elizabeth A. Harris
The rate of progression is variable with some patients progressing to dementia over a course of more than 10–15 years, and others within a few years. Many patients eventually display akinetic mutism in the final stages. Loss of language function to the point of muteness is uncharacteristic of AD and a distinguishing feature of FTD. Patients with isolated PPA may show isolated language impairment, without global development of dementia in as many as 50% of affected individuals. In those with concomitant MND, the time to death tends to be shorter, secondary to the more common sequelae of swallowing difficulty and aspiration pneumonia. Long-term prognosis for all cases is poor.
Non-Synonyms (Similar-Sounding)
Published in Terence R. Anthoney, Neuroanatomy and the Neurologic Exam, 2017
Akinetic mutism-1* (A&V, p. 257–258, 333): An imprecise term, used to label various (but not all) persistent conditions in which a patient docs not speak nor move though apparently alert, intact sensorily, and capable of speech and movement.
Neurological manifestations of COVID-19: a systematic review and detailed comprehension
Published in International Journal of Neuroscience, 2023
Zeina Hassan Ousseiran, Youssef Fares, Wafaa Takash Chamoun
Our review included 113 articles reporting many neurological manifestations that are classified into three categories: central nervous system, peripheral nervous system, and skeletal muscle manifestations. The central nervous system complications included headache, dizziness, stroke, ICH, encephalitis, acute myelitis, encephalopathy that can result in AMS and delirium, seizures and neuropsychiatric symptoms. In the peripheral nervous system, GBS was most frequently reported, followed by anosmia/ageusia and peripheral nerve palsy. Other uncommon manifestations include: hearing loss and tinnitus, akinetic mutism, tremors and multiple sclerosis. All of these symptoms can occur prior to any other respiratory symptoms and many were associated with higher degrees of disease severity, disability and mortality risk. This confirms the importance of considering these symptoms during the diagnosis of disease and to manage patients to prevent disease progression and development of unpredictable outcomes.
Akinetic mutism and the story of David
Published in Neuropsychological Rehabilitation, 2018
Rebecca Sinden, Barbara A. Wilson, Anita Rose, Nimisha Mistry
Akinetic mutism (AM) is a rare syndrome characterised by reduced motor function including facial expressions, gestures and speech output but with some degree of alertness following damage to the frontal lobe and/or frontal subcortical circuits (Nagaratnam, Nagaratnam, Ng, & Diu, 2004). It is sometimes seen in patients who are recovering from a disorder of consciousness (DOC; Formisano et al., 2011). There are many causes of AM including infarction with frontal lobe or bilateral thalamus damage, hydrocephalus, anoxia, an anterior communicating artery aneurysm, traumatic brain injury, stroke, carbon monoxide poisoning or tumour (Herklots, Oldenbeuving, Beute, Roks, & Schoonman, 2016). The first documented case of AM was reported by Cairns, Oldfield, Pennybacker, and Whitteridge (1941). They described a 14-year-old girl who suffered from a cystic tumour of the third ventricle causing recurrent episodes of mutism and immobility. The most profound characteristics were: Mutism, loss of feeling tone, loss of emotional expression, of spontaneous and of most other voluntary movements, and total incontinence of urine and faeces … she was incapable of originating active manifestations of any kind, with the notable exception that ocular fixation and movement occurred in response to the movement of external objects and to sounds (Cairns et al., 1941, p. 279).
Introduction to the Special Issue on Rare and Unusual Syndromes
Published in Neuropsychological Rehabilitation, 2018
Michael Perdices, Barbara A. Wilson
The paper “Akinetic mutism and the story of David” (pp. 234–243) describes the case of a 71-year-old man who, following a right middle cerebral artery stroke, developed akinetic mutism, a rare disorder associated with damage to the frontal lobe and/or frontal subcortical circuits. David’s case is also unusual because although individuals with akinetic mutism usually retain some degree of alertness, the syndrome is characterised by reduced motor function, including facial expressions, gestures and speech output, David spoke grammatically correct and clearly understandable sentences, albeit rarely. His case clearly illustrates the difficulties in accurately distinguishing between and accurately diagnosing disorders of consciousness.