BIPLEDs in akinetic mutism caused by bilateral anterior cerebral artery infarction.
Akinetic mutism cases due to bilateral anterior cerebral artery infarct.
Quinn, "Telephone effect in akinetic mutism from traumatic brain injury," Psychosomatics, vol.
Diagnoses Key finding to rule out considered Disorder of Assessment revealing x consciousness patient wakefulness and ability to communicate via eye gaze [down arrow] Upper cervical Observation of normal, x spinal quiet respiration and cord injury impairment of supraspinal muscles [down arrow] Akinetic mutism Lack of automatic x protective extension/ equilibrium reactions and no withdrawal to pain [down arrow] Locked-in Primary suspected [check] syndrome diagnosis by exclusion of other likely diagnoses Table 4: Primary classifications for disorders of consciousness.
Table Red flags for Creutzfeldt-Jakob disease in psychiatric patients Dementia (sudden onset, rapidly progressive) Myoclonus
Akinetic mutism Visual symptoms (ie, cortical blindness) Cerebellar symptoms Extrapyramidal symptoms Sleep disturbances Chorea
([double dagger]) Disease duration, the duration from onset to
akinetic mutism state or death if the patients never displayed
akinetic mutism.
Some patients with
akinetic mutism, for example, can vocalize and perform simple motor activities.
Figure Severity of impairment in goal-directed activity in disorders of diminished motivation LEAST Apathy * Noticeable lack of motivation that varies from baseline * Reduced goal-directed behaviors or cognition Abulia * More apparent decrease in spontaneous, purposeful movement * Less severe impairment than akinetic mutism GREATEST Akinetic mutism Akinetic = no movement Mutism = no speech * Patient is alert with visual tracking intact but appears immobilized due to motivational deficit Source: References 1-3 On hospital day 2, Ms.
Akinetic mutism secondary to subarachnoid hemorrhage
DPHL can be divided into 2 clinical variations: parkinsonism and
akinetic mutism. The former consists of conventional parkinsonian features along with agitation, apathy, hallucinations, dystonic posturing, and odd behaviors.
Masters proposed that probable CJD may be diagnosed in patients with rapidly progressive dementia, biphasic or triphasic waves on EEG, and at least two of myoclonus, visual or cerebellar symptoms, pyramidal or extrapyramidal signs, and
akinetic mutism (14).
CJD is a rapidly progressive neurodegenerative disorder characterized by cognitive changes, behavioral changes, gait disturbances,
akinetic mutism, and myoclonus.