An individual’s inability to move or speak can be referred to as akinetic mutism. It is most often confused to be a paralytic condition; however, that’s not the case. This article provides some information about this condition, what causes it, and its symptoms to help you understand the condition better.
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‘Locked-in syndrome’ wherein an individual is affected by paralysis and may interact only with his/her eyes is often confused with akinetic mutism. However, though eye movements may be similar in the two conditions, akinetic mutism is not associated with paralysis in any way.
Akinetic mutism is characterized by an individual’s inability to move or speak. It is a term that is used medically and is believed to be associated with the mental state of an affected individual. However, in this case, the affected individual is alert and he/she may make active eye movements in response to a person or sound. Furthermore, it is not associated with paralysis. However, those affected show apathy to move, stating a resistance even on attempting to do so. That is, even if they attempt to do so out of will, there is a resistance that acts back on them. Moreover, their way of expressing speech may be in the form of a whisper, but of words with only one syllable. This condition is said to vary for each affected individual.
The brain comprises various parts that are responsible for an individual’s normal and proper movement and speech. These include the frontal lobe, the basal ganglia, the thalamus, mesencephalon, etc. Damage to any of these parts may lead to akinetic mutism.
There are two forms of akinetic mutism that are based on the anatomic position of the injury. While one involves damage to the bilateral frontal lobe and is known as hyperpathic akinetic mutism, the other involves damage to the mesencephalic region (or midbrain) and is known as somnolent or apathetic akinetic mutism.
There are various causes of akinetic mutism, often taking place after an injury to the brain or as a symptom of other diseases. Some of them are:
• As mentioned above, severe damage to the frontal lobe results in the said condition.
• It is also most commonly caused by a thalamic stroke, wherein the thalamus is damaged.
• Damage or surgical removal of cingulate gyrus is one of the causes.
• Creutzfeldt-Jakob disease is a rare brain disease that can be fatal. Akinetic mutism can be an indication of this disease in some cases.
• Damage to the brain that is caused by the exposure to certain drugs or toxins may also result in akinetic mutism.
• Tumors and traumas involving the brain region like the frontal lobe, etc., may also be a cause.
• Other causes include meningitis, presence of cysts, demyelinization, infections of the central nervous system, hydrocephalus, etc.
The symptoms are known to make their first appearance about four months prior to the condition, and further progress with time. Some of the symptoms are:
• Inability to move
• Inability to speak
• Absence of facial expressions
• Absence of emotions and enthusiasm
• Loss of inhibition
Many a time, this condition is mistaken with depression, delirium, or other conditions associated with the state of mind, mainly due to the similar symptoms. Due to this, proper diagnosis of the condition is important, which would further enable proper treatment. Moreover, the treatment for each individual who is affected by akinetic mutism may be different. This would depend on the cause and other factors.
The diagnosis is usually done by conducting MRI scans. Furthermore, cerebrospinal fluid samples may be collected to detect whether infections could be the cause. Once the cause is detected, the treatment would begin accordingly by mainly targeting the causal agent. Treatments may include the use of intravenous magnesium sulfate, puncturing cyst, therapy involving the use of dopamine agonists, etc.
The treatments for this condition have proven beneficial in most cases either to reduce the symptoms or even to get rid of it. Thus, the correct diagnosis and a prompt treatment plays an important role in the recovery of the patient.
Disclaimer: This article is for informative purposes only and should not be substituted for the advice of a medical professional.