Akinetic mutism – causes, symptoms & therapy

Akinetic Mutism

Akinetic mutism is not an independent disease, but can have its origins in various causes of the disease. This guide explains in six sections how akinetic mutism is defined, its causes and symptoms, and treatment options. If there are signs of akinetic mutism, it is important to seek professional help in neurologically specialized clinics.

What is Akinetic Mutism?

Akinetic mutism is a neurological disease . Mutism describes the fact that the patient cannot speak due to the lack of drive. In addition, he cannot move, which is represented by the term akinesia. Akinesis comes from the ancient Greek word “kinesis” for “movement”, hence akinesia means lack of movement. This results in the pathological unconsciousness of the heart and skeletal muscles. The patient is unable to speak or move, but is still conscious and not paralyzed. However, he cannot remember most of the events.

causes

  Akinetic mutism usually results from brain injury. Either the frontal brain or the cingulate gyrus is affected. The Latin term “gyrus” stands for whorl, the term “cinguli” for girdle or girdle whorl. The cingulate gyrus is part of the limbic system. The limbic system works to process any emotion and is the source of drives and at the same time their transmitter. Such brain injuries are usually the result of strokes and craniocerebral trauma , such as concussions after a hit or accident to the head.In addition, akinetic mutism can result from pressure on the diencephalon, which is often exerted by tumors of various types or by hydrocephalus. Hydrocephalus is the Latin term for a hydrocephalus. Spongiform – sponge-like – encephalopathies are also seen as the cause of akinetic mutism. Encephalopathies represent various injuries to the brain with different causes and forms. Usually, a perforated structure of the brain is spoken of as a result of these spongiform encephalopathies. Creutzfeldt -Jakob disease is a frequently cited example of the occurrence of spongiform encephalopathies. In Creutzfeldt-Jakob disease, however, akinetic mutism usually does not develop until the late stage.

When to the doctor?

A doctor should be consulted if a child develops any noticeable and unusual developmental delays. If it does not learn to speak or does not move compared to its peers, it is advisable to consult a doctor. If the symptoms appear suddenly and unexpectedly, you should also see a doctor.

If there are changes in speech or motor skills in an adult, a doctor must be consulted. Brain disorders, an accident or an injury can cause damage to certain areas of the brain, leading to behavioral changes and cognitive impairment. As soon as the affected person experiences an unusual change in personality or a loss of motor skills, a doctor must be contacted. If movements can no longer be controlled or if the entire motor function becomes very flat, there is cause for concern.

A lack of emotion, a lack of interest in what is happening in the immediate vicinity, and a strong apathy must be examined and diagnosed. If the person concerned no longer speaks, although there is no hoarseness or injury to the larynx, a doctor must be consulted immediately. If other symptoms occur, a doctor’s visit is necessary. This can include impaired consciousness, loss of knowledge or problems with orientation. Fever, limitations in the ability to perceive and react must also be clarified by a doctor.

symptoms and course

Akinetic mutism is accompanied by numerous symptoms, and the course of the disease cannot be determined in general terms. The obvious symptoms of this neurological disease are the patient’s lack of physical exercise and silence. The akinesia and mutism do not occur due to impaired perception or neuronal incompetence, but due to the lack of transmission of drives by the limbic system. Associated with this is the resulting lack of emotion on the part of the patient.

They appear paralyzed when in fact they are fully conscious, lacking only the drive to speak and move. This connection was confirmed by conversations between the Portuguese neuroscientist António Rosa Damásio and those affected who had survived akinetic mutism. Those affected perceived events, but could not interact. Nevertheless, there is evidence that patients have patchy memories during their illness. With regard to the course of the disease, there are no binding statements about the required period of time or the required type of healing. Rather, it depends on the cause of the disease. Full recovery is still possible, provided the patient has not suffered severe brain injury.

Diagnose

Magnetic resonance imaging (MRI) is usually used to diagnose akinetic mutism . A sample of cerebrospinal fluid is usually also used, in which the cerebrospinal fluid is examined for inflammatory causes. Electroencephalography (EEC) also records electrical currents in the brain. Especially in akinetic mutism, differential diagnoses must be considered, hence diseases with similar symptoms. These include, among other things, the locked-in syndrome and parasomnia, which causes a disorder of the adult, especially in children. It is not uncommon for akinetic mutism to be associated with abulia (lack of pathological will on the part of the patient) or catatonia, Greek for relaxation.

complications

Depending on the underlying cause of akinetic mutism, different treatments can be considered. These treatments can also cause complications. For example, when a brain tumor is surgically removed, there is a possibility that the surrounding brain tissue will be damaged. In this case, for example, various neurological symptoms are possible. Its type depends on the brain area affected. Even if the tumor can be successfully removed and only as much tissue is removed as is necessary, neurological impairments can remain. Radiation or chemotherapy to treat a brain tumor can also cause medical complications.

Common side effects of chemotherapy include nausea, vomiting, weight loss , and hair loss. Inflammation of the mucous membranes also occurs relatively often. Allergies, neurological complaints and heart damage are less common. In some cases, patients are given additional medication to improve their tolerance to chemotherapy and alleviate their symptoms. There are also possible psychological complications. These are particularly likely if the patient is conscious despite akinetic mutism. However, psychological problems can also arise when the sufferer recovers from akinetic mutism. Depression , for example, depends on the general condition of the patient and his other life situation, fears, traumatization, stress and other mental disorders and symptoms possible.

treatment and therapy

The type of treatment or therapy for akinetic mutism depends primarily on the cause of the disease and when treatment is started. Akinetic mutism cannot always be cured. However, the chances of effectively combating the disease increase if those potentially affected are brought to clinics that specialize in neurological diseases of this type. Akinetic mutism cannot be cured, for example, in the case of malignant tumors that cannot be completely removed or that spread too quickly and extensively in the body. In the case of diseases such as Creutzfeldt-Jakob disease, a cure is almost impossible. This usually results in the death of those affected within a few months,

Death can also occur if it starts as a result of a stroke or traumatic brain injury. To treat strokes, doctors rely on self-recovery or prescribing certain medications, such as anticoagulants . Benign or malignant removable tumors are often treated with radiation after their removal. Medication is also used to reduce intracranial pressure due to hydrocephalus or other causes of the disease.

In some cases, people may need to have a decompressive craniectomy, in which part of the brain is surgically removed. If the brain pressure is successfully reduced or if healing is foreseeable, the removed parts of the brain are usually reinserted. Research on akinetic mutism repeatedly reports that if the treatment or therapy is successful, those affected and their immune system recover quickly. Patients also regain their instincts to talk and move in a very short time.

prevention

The prevention of akinetic mutism also depends on the cause of the disease. Brain tumors or diseases such as Creutzfeldt-Jakob disease are often unpreventable. This disease is genetically determined and is caused by so-called prions – disease-causing proteins. Neither are hydrocephalus or craniocerebral trauma preventable. However, preventive measures can be taken against strokes, such as sufficient physical activity or a healthy diet to avoid cholesterol, high blood pressure or obesity. Avoiding alcohol and cigarettes also helps prevent it.

Dorothy Farrar

Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.

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