Akinetic mutism--not coma.
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.
Shetty
Anita Chittaranjan
AC
Department of Geriatric Medicine, The University of Sydney, Westmead Hospital, NSW 2145, Australia.
Morris
John
J
O'Mahony
Paul
P
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*
D000927:Anticonvulsants