Akinetic mutism and parkinsonism associated with obstructive hydrocephalus.
We report the case of a patient with idiopathic aqueductal stenosis and hydrocephalus who had several episodes of akinetic mutism, each preceded by shunt malfunction, that resolved with shunt revision. She also developed a parkinson's syndrome resistant to shunt revision but responsive to antiparkinsonian medications. The parkinson's syndrome and the episodes of akinetic mutism may be related to a reduction of dopaminergic input to the striatum and to the cingulate and frontal cortex brought about or worsened by ventricular dilatation.
D000328:Adult; D000405:Akinetic Mutism / Q000209:etiology*; D001927:Brain Diseases / Q000000981:diagnostic imaging; D002535:Cerebral Aqueduct / Q000000981:diagnostic imaging; D014695:Cerebral Ventriculography; D002557:Cerebrospinal Fluid Shunts; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D010300:Parkinson Disease / Q000150:complications*; D014057:Tomography, X-Ray Computed