title: Akinetic mutism--not coma.
abstract: We describe a case of akinetic mutism mistaken as coma. A 77-year old lady presented with apparent unresponsiveness. In fact she responded when stimulated. She subsequently developed movements typical of clonic perseveration, erroneously treated as seizures. She also had features of a frontal lobe syndrome. Initial CT scan showed no abnormality; it was only after an MRI scan that a diagnosis of bilateral paramedian thalamic infarction was made. MRI scanning should be considered early in the investigation of patients with atypical neurological presentation.
authors.affiliation: Department of Geriatric Medicine, The University of Sydney, Westmead Hospital, NSW 2145, Australia.
authors.forename: Anita Chittaranjan
authors.initials: AC
authors.lastname: Shetty
authors.forename: John
authors.initials: J
authors.lastname: Morris
authors.forename: Paul
authors.initials: P
authors.lastname: O'Mahony
mesh_terms: D000368:Aged; D000405:Akinetic Mutism / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D000927:Anticonvulsants / Q000627:therapeutic use; D002544:Cerebral Infarction / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D003128:Coma / Q000175:diagnosis*; D003951:Diagnostic Errors; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009068:Movement; D009460:Neurologic Examination; D012640:Seizures / Q000175:diagnosis* / Q000188:drug therapy; D012677:Sensation; D013788:Thalamus / Q000473:pathology*
chemical_list: D000927:Anticonvulsants