Mutism

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Related to akinetic mutism: hemiballismus, Locked in Syndrome

mutism

[′myü‚tiz·əm]
(medicine)
Inability or refusal to speak.

Mutism

 

the inability or refusal to speak that takes place in the absence of any organic lesions of the vocal apparatus. Occurring mainly in shy, timid, physically weak children, mutism results from a reaction to a traumatic mental stimulus such as fright, insult, conflict, or excessive demand. Mutism is also found in patients suffering from schizophrenia and hysteria. Hysterical mutism is usually complete, that is, the patient does not utter a single word; he does not maintain oral contact but communicates by writing. The ability to speak disappears suddenly and returns just as unexpectedly. Voluntary mutism is common in children: the child does not answer questions in school but talks normally at home and in the street. Sometimes he does not answer the questions of one teacher but does respond normally to others.

Mutism is temporary but varies in duration. It sometimes continues for years, in which case it causes mental retardation. Treatment involves the elimination of factors that traumatize the nervous system; treatment of the disease that caused the mutism; use of general restorative measures; and psychotherapy. Preventive measures include strengthening of the child’s nervous system and a proper upbringing that encourages independence, activity, and sociability.

Surdimutism—the functional impairment of hearing and speech—is a special form of the condition. Unlike deaf mutism, which is caused by the permanent organic impairment of hearing, surdimutism is temporary. It is generally observed in wartime as one of the symptoms of contusion. Speech and hearing in surdimutism are usually quickly restored by disinhibition therapy. Sometimes surdimutism can be corrected without any special treatment. In a few cases the disease becomes protracted and requires the coordinated attention of neurologists, otorhinolaryngologists, speech therapists, and specialists in the teaching of deaf-mutes.

L. V. NEIMAN

References in periodicals archive ?
Poser, "Akinetic mutism as a classification criterion for the diagnosis of Creutzfeldt-Jakob disease," Journal of Neurology, Neurosurgery & Psychiatry, vol.
Diminution of basal ganglia dopaminergic function may play an important role in the generation of akinetic mutism in a patient with anterior cerebral arterial infarct.
Diu, "Akinetic mutism following stroke," Journal of Clinical Neuroscience, vol.
The emergence of motor impairment (gait abnormality), change in consciousness level (mental dullness and akinetic mutism), and the episode of seizure showed the clinical picture of encephalopathy, which initiated further investigations.
(5) During the final stages of the disease, patients may suffer from akinetic mutism and inability to swallow, which often leads to aspiration pneumonia.
Cranial MRIs were normal after the onset of visual loss, dementia, and hallucinations in our patient, and bilateral diffusion restriction was observed in the basal ganglia in the follow-up MRI following the akinetic mutism (Figure 1A).
She was paralyzed and mute, a condition known as akinetic mutism.
To ascertain the clinical features of prion diseases, we analyzed the patient's age at onset and duration of disease course, which was calculated as the interval between the onset and the appearance of the akinetic mutism state or death in the patients who died without akinetic mutism.
-- Appropriate treatment of apathy, abulia, and akinetic mutism requires an accurate diagnosis of impairment type, individualized treatment, and optimized general medical care using a multidisciplinary approach, according to Barry S.
Some sources support distinct diagnoses, while the traditional position is that DDM are variations along a spectrum, with apathy as the mildest form and akinetic mutism as the most severe form (Figure, page 12).
A B C (1) Periodic sharp (1) Myoclonus wave complexes on Routine (2) Visual or EEG during an investigations that cerebellar signs illness of any do not indicate an duration alternative (3) Pyramidal/ diagnosis extrapyramidal signs (2) Positive 14-3-3 CSF assay in (4) Akinetic mutism patients with a disease duration of less than 2 years (3) MRI high signal abnormalities in caudate nucleus and/ or putamen on diffusion weighted or fluid attenuation inversion recovery imaging (1) Definite sCJD = diagnosed by standard neuropathological techniques; and/or immunocytochemically and/or Western blot confirmed protease-resistant PrP and/or presence of scrapie-associated fibrils.
She remained in a state of akinetic mutism and died in June 2004, [approximately equal to] 32 months after illness onset.