61. Movement HYPOKINETIC MOVEMENT DISORDERS. Rigid Akinetic Movement Disorders. Parkinsonism.Stiff Man Syndrome. akinetic mutism. Psychomotor Retardation. http://www.cmdg.org/movement_disorder_info.htm

Movement Disorder Types Tremor Huntington's Disease Dystonia Other Choreas ... Back to CMDG Homepage Movement Disorders Summary Movement disorders are common problems in the Canadian population. Recognizing and identifying the type of movement disorder can provide a major clue toward solving the diagnostic puzzle. The first step in this process is to be able to identify the " phenomenology " (the type) of the movement disorder. Movement disorders can be divided into disorders of too much movement ("Hyperkinetic") and disorders of too little movement ("Hypokinetic"). The latter group is referred to as the rigid akinetic syndromes , of which Parkinson's Disease would be the most typical example. HYPERKINETIC MOVEMENT DISORDERS TREMOR: A rhythmical sinusoidal oscillation of a body part DYSTONIA: An involuntary muscle contraction causing a sustained twisted or abnormal posture" MYOCLONUS: A lightening like jerk of a body part. STEREOTYPY: Any patterned, stereotypic movement.

62. NLC: Glossary Of Terms agraphia Inability to write. akinetic mutism - Also known as a persistentvegetative state. The patient neither moves nor speaks http://www.neurolaw.com/gloss1.html

ROLE BRAIN INJURY SPINAL INJURY ] [GLOSSARY] [ RESOURCES CONTACT US INDEX: To go directly to a section, click on a letter below. A B C D ... XYZ A (abducens nerve - axonotmesis abducens nerve - Cranial Nerve VI. Supplies lateral rectus, an extrinsic muscle of the eye. abscess - A localized collection of pus in a cavity, formed by the disintegration of tissues. absence epilepsy - A type of epilepsy that occurs especially in children and is manifested by a sudden momentary loss of consciousness with minimal motor manifestations. acoustic neuroma - A tumor or new growth which involves the acoustic division of the eighth cranial nerve, largely made up of nerve cells and nerve fibers. acute care - Care provided during the very early stages following injury, including surgery and intensive care. Focus is on the patient becoming medically stable. acute rehabilitation program - Primary emphasis on the early rehabilitation phase which usually begins as soon as a person is medically stable. The program is designed to be comprehensive and based in a medical facility with a typical length of stay of 2-3 months. Treatment is provided by and identifiable team in a designated unit. ADL - Activities of daily living. Routine activities carried out for personal hygiene and health (including bathing, dressing, feeding) and for operating a household.

63. Neurolaw agraphia Inability to write. akinetic mutism - Also known as a persistentvegetative state. The patient neither moves or speaks http://www.neurolaw.com/indextemplate.cfm?file=AGlossary.htm

64. Canadian Psychiatric Association - Bulletin - February 2002 Syndromic differential diagnosis includes parkinsonism, the serotonin syndrome,akinetic mutism due to neurologic disorders, delirium, nonconvulsive status http://www.cpa-apc.org/Publications/Archives/Bulletin/2002/february/specialFeatu

Neuropsychiatry Current Concepts of the Pathophysiology of Catatonia Robert Stowe, MD, FRCPC Clinical Assistant Professor, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia; Medical Manager, Acute Neuropsychiatric Assessment and Treatment Unit, Riverview Hospital, Port Coquitlam, British Columbia. Abstract: This article reviews the clinical differential diagnosis and phenomenology of catatonia in the context of neuroanatomical, neurophysiological and neurochemical observations that may help to elucidate our pathophysiological understanding of this complex and fascinating neuropsychiatric syndrome. Résumé : Concepts actuels de la physiopathologie de la catatonie Cet article se penche sur le diagnostic différentiel clinique et la phénoménologie de la catatonie à la lumière d’observations neuroanatomiques, neurophysiologiques et neurochimiques qui permettraient de préciser la physiopathologie de ce syndrome neuropsychiatrique complexe et fascinant. Key Words: catatonia The pathophysiology of catatonia is complex and includes alterations in dopamine and other neuro- transmitter systems, possible ion channel abnormalities, and dysfunction of frontal-neocortical, limbic and even brainstem circuitry.

65. Mixed Dysarthrias & Other Neurogenic Speech Disorders Include such disorders as Persitent vegetative state; akinetic mutism; Has beensuggested that “aphasic” mutism reflects dysfunction in frontal lobe http://www.ucs.louisiana.edu/~ncr3025/roussel/codi555/multiplesite.html

CODI 555 Motor Speech Disorders Mixed Dysarthrias: Common Etiologies ALS - flaccid-spastic (?ataxic) MS - spastic-ataxic (variable could have all other types mixed in) Shy-Drager - spastic-ataxic-hypokinetic PSP - spastic-hypokinetic Parkinson’s Disease - hypokinetic-hyperkinetic Wilson’s Disease - spastic-ataxic-hypokinetic Neurogenic Mutism Patient may be mute i.e. complete lack of speech for a number of reasons Most common include: Severe dysarthria (anarthria) Severe apraxia of speech Aphasia Cognitive/affective disorders Anarthria Most have spastic, hypokinetic or a mixed dysarthria with both spastic and hypokinetic symptoms Most frequent etiology of above are vascular lesions especially brainstem CVA Also associated with rare conditions Locked in Syndrome Bi-opercular Syndrome Apraxia of Speech Not unusual, but often lasts for only a few days post-onset Mutism often resolves into vocal apraxia (whisper phonation) Characteristics of vocal apraxia Difficuly initiating and/or sustaining vocalization Prosodic problems (pitch variation) Difficulty controlling volume Respiratory effort Deviations of voice quality Aphasia Mutism not uncommon in acute period Persistent mutism (even in global aphasia) is uncommon May be more common with subcortical aphasias (lesions in thalamus and basal ganglia) Cognitive/Affective Deficits Group of disorders of arousal reflecting damage to reticular activating system (RAS) Include such disorders as: Persitent vegetative state

66. Curso De Neurología De La Conducta Y Demencias A clinical and pathologic study of akinetic mutism . Neurology 10 1021. Stateresembling akinetic mutism in basilar artery occlusion . Neurology 17 74-80. http://oaid.uab.es/nnc/html/entidades/web/15cap/c15_13.html

[1] Aggleton, J.P. (1992). The Amygdala: Neurobiological Aspects of Emotion, Memory, and Mental Dysfunction. J.P. Aggleton (ed.) Wiley-Liss, Nueva York. [2] Alexander, G.E., Delong, M.R., Strick, P.L. (1986). "Parallel organization of functionally segregated circuits linking the basal ganglia and cortex". Annu Rev Neurosci 9 [3] Alexopoulous, G.S., Meyers, B.S., Young, R.C., Campbell, S., Silberweig, D., Charlson, M. (1997) "Vascular depression hypothesis" Arch Gen Psychiatry [4] Ali-Cherif, A., Royere, M.L., Gosset, A., Poncet, M., Salamon, G., and Khalil, R. (1984). " Troubles du comportement et de l'activité mentale après intoxication oxycarbonée: lésions pallidales bilatérales" Rev Neurol [5] Amyes, E.W., y Nielsen, J.M. (1953). " Bilateral anterior cingulate gyrus lesions" Bull Los Angeles Neurol Soc [6] Aylward, E.H., Roberts Twillie, J.V., Barta, P.E., et al. (1994). "

67. Psyche 6(8): Review Of Antonio Damasio's "The Feeling Of What Happens" By Aldo M seizure, during which a patient may even walk out of the door and in the street,but is clearly not selfconscious; and the akinetic mutism of patients who http://psyche.cs.monash.edu.au/v6/psyche-6-10-mosca.html

Antonio Damasio's Book The Feeling of What Happens may be purchased from Amazon.Com A Review Essay on Antonio Damasio's The Feeling of What Happens: Body and Emotion in the Making of Consciousness Aldo Mosca 66 West 12th Street, Room 604 New School University New York, NY 10011 U.S.A. moscaa@newschool.edu http://homepage.newschool.edu/~moscaa PSYCHE, 6(10), October 2000 http://psyche.cs.monash.edu.au/v6/psyche-6-10-mosca.html KEYWORDS: emotions, consciousness, self, neuropathology. REVIEW OF: Antonio Damasio (1999). The Feeling of What Happens: Body and Emotion in the Making of Consciousness. New York: Harcourt Brace. 386pp. ISBN: 0156010755. US$15 pbk Abstract. Here I present a sympathetic but critical analysis of Damasio's latest book. I begin with a brief exposition of his neurobiological theory of emotion and then take issue with him on the cognitive and representational nature of emotional states. I discuss his view of consciousness as a second-order set of neural activations, which are allegedly intimately related to, and even necessary for, elementary emotional and homeodynamic processes. I find Damasio's account wanting in at least two respects. First, the relationship between emotional states and the consciousness thereof is left ambiguous. Second, Damasio lacks a clear psychological hypothesis about the hierarchy of first-, second-, and possibly third-order mental/neural states. The result is that a wealth of neurobiological information fails to be organized in a coherent conceptual scheme, and the whole account is ultimately unsatisfactory.

68. Akinetic Mutism Website Results :: Linkspider UK akinetic mutism Websites from the Linkspider UK. akinetic mutism Directory.Complete Results for akinetic mutism Related Topics. http://www.linkspider.co.uk/Health/ConditionsandDiseases/NeurologicalDisorders/B

Akinetic Mutism Websites from Linkspider UK Keyword: Akinetic Mutism Linkspider UK Directory Akinetic Mutism Search for Directory Tree: Top Health Conditions and Diseases Neurological Disorders ... Brain Diseases : Akinetic Mutism (2) Add URL Advertise Here! Personalize Amazon ... Medicine Net - An article about akinetic mutism, what it is, the cause and symptoms. WorldMedicus - A description of akinetic mutism, with synonyms, related subjects and a link to reviews and editorials.

69. Glossary Of Terms Adenohypophysis Adenoids Aditus Ad Antrum Aditus Of The Larynx Afferent AfferentLimb Agnosia Agraphia Akathisia Akinesia akinetic mutism Alar Ligaments Alexia http://medlib.med.utah.edu/kw/hyperbrain/glossary/a.htm

Abducens Nerve Abducens Nucleus Absence Seizure Acalculia Abducens Nerve Abducens Nucleus Absence Seizure Acalculia ... Axon Hillock

70. Arch Gen Psychiatry -- Page Not Found related emotional responses. More profound states of apathy includeabulia or akinetic mutism in the extreme. Similar to depression http://archpsyc.ama-assn.org/issues/v55n9/ffull/ylt0998-1.html

Select Journal or Resource JAMA Archives of Dermatology Facial Plastic Surgery Family Medicine (1992-2000) General Psychiatry Internal Medicine Neurology Ophthalmology Surgery MSJAMA Science News Updates Meetings Peer Review Congress The page you requested was not found. The JAMA Archives Journals Web site has been redesigned to provide you with improved layout, features, and functionality. The location of the page you requested may have changed. To find the page you requested, click here HOME CURRENT ISSUE PAST ISSUES ... HELP Error 404 - "Not Found"

71. Conditions That Resemble Coma akinetic mutism Patients with damage to thalamic reticular structures may opentheir eyes to stimuli, but fail to make any meaningful response to stimuli. http://www.medinfo.ufl.edu/year2/neuro/neuroexam/v221.html

Neurological Examination Examination of the Comatose Patient Previous Page Next Page Conditions that resemble coma The Locked-in Syndrome Patients who have bulbar and limb paralysis may look comatose, because they cannot speak or move in response to commands, but may actually be fully awake. Lesions that interrupt the corticobulbar and corticospinal pathways in the base of the pons, but spare the peri-acqueductal reticular formation in the tegmentum of the pons and midbrain, can produce this clinical picture, that has been aptly named the locked-in syndrome. Brain stem stroke from basilar artery thrombosis is the most common cause. In these patients, vertical eye movements, mediated by pathways in the midbrain tegmentum, are usually spared. Therefore, consciousness may be ascertained by asking the patient to look up or down. If the patient obeys, you may develop a code of eye movements (e.g., "look up for yes,' down for no'") to test mental status. The EEG in these patients shows a normal awake pattern when they are aroused, and the normal EEG phases of sleep. Less commonly, polyradiculoneuropathy (Guillain-BarrÇ syndrome) may produce a similar picture. If eye movements are not spared, the EEG may be the only means of distinguishing this state from coma. Persistent Vegetative State These patients may appear to be awake, because their eyes are open, but they are functionally comatose. They show no evidence of comprehending what is happening around them, and they make no meaningful response to commands. They may withdraw their limbs appropriately from painful stimuli, or they may demonstrate decorticate posturing. They may regain sleep-wake cycles, but their awake EEG is slow. Several different mechanisms may account for similar syndromes:

72. NEUROLEPTIC MALIGNANT SYNDROME he comments The central feature was impairment of vocalization and diminutionof psychomotor activities eventually leading to akinetic mutism (coma vigil). . http://www.idiom.com/~drjohn/biblio.html

NEUROLOGIC MALIGNANT SYNDROME (NMS) A CHRONOLOGICAL ANNOTATED BIBLIOGRAPHY prepared by John M. Friedberg, MD February 5, 1997 Case reports of NMS and literature reviews were readily available in both psychiatric and neurologic journals from 1956, a few years after the introduction of the first phenothiazine, Chlorpromazine (Thorazine). As this chronology shows, there was a flurry of reports throughout the decade of the 1970's. As stated in a The Neuroleptic Malignant Syndrome and Related Conditions*: "Interest and increased awareness in febrile catatonic states associated with neuroleptic administration was quite evident by the mid 1970's. At this time, NMS had been fairly well reported in France, Japan and England. Several American authors cognizant of the French reports, also began to use the term neuroleptic malignant syndrome to describe similar cases in the United States." (p 5) The French were the first to observe the artificial hibernation produced by the anti-histamine related group of drugs called phenothiazines and the first to apply this observation for human behavioral control. It is not surprising that the very term Neurologic Malignant Syndrome is a translation of the French term "syndrome malin des neuroleptiques." Despite the recent obfuscation (e.g. in the book cited above) of NMS and "Lethal Catatonia of Stauder," the epidemic of NMS which followed the epidemic of neuroleptics in the 1860's was clearly a new and alarming phenomenon.

73. Behavioral Examination Of The Brain f. Automatic obedience. g. Stupor (akinetic mutism). h. Echophenomena.4. Comment on the association of mutism, immobility and catatonia. http://www.finchcms.edu/cms/Psychiatry/cns/web files/Behavioral Examination of t

Objectives I. Overall Goal Given a patient or patient vignette, assess the patient’s brain functioning. II. Specific Objectives A. State the sensitivity of behavioral assessment as a measure of brain functioning. B. Compare the reliability of behavioral observations with other observations in the physical examination. C. State the goals of the behavioral brain examination. D. Summarize the guidelines for the behavioral brain examination, including the following: Empathy Active listening Conversational features Avoiding interrogatory terms and intimidating actions Balancing open- and closed-ended questions Progressing logically E. Discuss the phenomenologic approach to behavioral assessment, including the following: Objective observation Precision of terms Separation of form from content F. Summarize the behavioral brain examination, including the following: Identifying the chief complaint and putting it into the context of the specific patient Developing an initial differential diagnosis based on the chief complaint Asking screening questions based on the initial diagnostic list Following up on endorsed screening questions Having identified the clinical syndrome, deciding whether it is primary or secondary

74. Brain-Mind.com Barris and Schuman (1953) describe one patient who rapidly developed akinetic mutismand indifference following bilateral strokes to the anterior cingulate and http://www.brain-mind.com/Catatonia.html

Brain-Mind.com Catatonia From: Neuropsychiatry, Neuropsychology, Clinical Neuroscience by R. Joseph, Ph.D. Catatonia The rather rate and unsual disorder of catatonia, is due to abnormalities in the functional integrity of the medial frontal lobe and adjacent structures, including the anterior cingulate and head of the caudate (Joseph, 1999). Damage to this area can result in mutism, a paralysis of will, and a paralysis of movement, such that patients may remain in the same posture for hours, days, or even weeks at a time. The SMA, however, appears to be concerned with gross body movements, as well as vocalization, and is concerned with the general problem of guiding and coordinating the movement of the extremities through space (Andres, et al., 1999; Passingham, 1997; Rizzollati, 1998; Stephan, 1999). Electrical stimulation of the medial frontal lobes will produce complex semipurposeful movements, vocalizations (Penfield and Jasper 1954), and postural synergies involving the trunk and extremities bilaterally (Van Buren and Fedio 1976). Moreover, single cell recordings (Brinkman and Porter 1979; Tanji and Kurata 1982) blood flow studies (Orgogozo and Larsen 1979; Shibasaki et al. 1993), movement related evoked potentials (Ikeda et al. 1992) and functional imaging studies (Passingham, 1997) indicate increased activity in the SMA and medial tissues while performing and even imagining complex movements of the fingers and hands. Hence, with massive lesions to this area of the brain, patients may become so stiff and unmoving that they appear catatonic and lose even the will to speak (Hasslet 1980; Joseph, 1999a; Laplane et al. 1977; Luria 1980; McNabb et al. 1988; Penfield and Jasper 1954; Penfield and Welch 1951; Watson et al. 1986).

75. From The BMJ to have any two of the following symptoms myoclonus; visual or cerebellar symptoms,or both; pyramidal or extrapyramidal signs, or both; or akinetic mutism. http://bmj.com/collections/bse/21-02-pr1.htm

BMJ No 7131 Volume 316 Papers Saturday 21 February 1998 Diagnosis of Creutzfeldt-Jakob disease by measurement of S100 protein in serum: prospective case-control study See Editorial by Pocchiari, p 563 Abstract Objective: To analyse serum concentrations of brain specific S100 protein in patients with Creutzfeldt-Jakob disease and in controls. Design: Prospective case-control study. Setting : National Creutzfeldt-Jakob disease surveillance unit. Subjects: 224 patients referred to the surveillance unit with suspected Creutzfeldt-Jakob disease and 35 control patients without dementia. Main outcome measure: Serum concentration of S100 protein in patients with Creutzfeldt-Jakob disease, in patients with other diseases causing dementia, and in the control group. Results: Of the 224 patients with suspected Creutzfeldt-Jakob disease, 65 were classed as definitely having the disease after neuropathological verification, an additional 6 were classed as definitely having the disease as a result of a genetic mutation, 43 as probably having the disease, 36 as possibly having the disease, and 74 patients were classed as having other disease. In the 108 patients classed as definitely or probably having Creutzfeldt-Jakob disease the median serum concentration of S100 was 395 pg/ml (SD 387 pg/ml). This was significantly higher than concentrations found in the 74 patients classed as having other diseases (median 109 pg/ml; SD 177 pg/ml; P=0.0001). At a cut off point of 213 pg/ml sensitivity for the diagnosis of the disease was 77.8% (95% confidence interval 68.8% to 85.2%) and specificity was 81.1% (70.3% to 89.3%). There was a significant difference in survival at different concentrations of S100 in Kaplan-Meier curves (P=0.023).

76. New York County Medical Society - News Flash: RE: Surveillance For Transmissible out of the following four clinical features Myoclonus; Visual orcerebellar signs; Pyramidal/extrapyramidal signs; akinetic mutism; http://www.nycms.org/article_view.php3?view=489&part=2

77. Agricultural And Biosystems Engineering @ Iowa State Univeristy Tremor * Speech disturbances * Epilepsy * Abdominal cramps * Mimics flulike viralillness * Paraesthesiae * Parkinsonism * akinetic mutism * Acidosis of http://www.abe.iastate.edu/human_house/conditions.asp

College of Agriculture College of Engineering Iowa State University About ABE ... Search ISU Extension Pub # none: electronic file only Author: Thomas H. Greiner, Extension Agricultural Engineer Department of Agricultural and Biosystems Engineering, Iowa State University. September, 1997 TWO CONDITIONS FOR A CARBON MONOXIDE HAZARD 1. Carbon monoxide must be produced 2. Combustion gases must be released into the structure. If either one or two is present, 50% of the hazard exists. One factor of safety is gone. If both exist, THERE IS A SEVERE PROBLEM 1. Complete combustion does NOT produce carbon monoxide Check for complete combustion 1. Measure gas flow 2. Measure air/fuel/dilution 3. Measure CO in combustion products 4. Check venting 2. Combustion gases must be released into the structure. Common causes: Vent failure Unvented appliances Internal combustion engines CARBON MONOXIDE PROBLEMS ARE SUBTLE Carbon monoxide is a deadly, lethal poison. It is called the "Quiet Killer" and "The Great Imitator."

78. 1Up Health Health Links Directory Conditions And Diseases Conditions and Diseases Neurological Disorders Brain Diseases AkineticMutism . Uncover resources and links to Web sites related http://www.1uphealth.com/links/brain-diseases-akinetic-mutism.html

79. January 29-31, 1999 Getting To The Heart Of The Matter: (jan29get.htm) It’s just that the overdose did leave Audrey in an akineticmutism state. Thatmeans, Audrey cannot move herself (akinetic) and she cannot speak (mutism). http://www.dailycatholic.org/issue/99Jan/jan29get.htm

DAILY CATHOLIC FRI-SAT-SUN January 29-31, 1999 vol. 10, no. 20 GETTING TO THE HEART OF THE MATTER To print out entire text of Today's issue, go to SECTION ONE and SECTION TWO and SECTION THREE INTRODUCTION "Getting to the Heart of the Matter" is what Sister Mary Lucy Astuto pinpoints in every issue when she takes a common sense approach to living our faith with her practical columns. In this issue, she seeks to clarify the controversy and misinformation surrounding Audrey Santo who has been under investigation by the Diocese of Worcester, Massachusetts because of the spiritual phenonena connected to this victim soul in her home. Sister Lucy knows first hand the facts for she personally has visited with little Audrey and her mother and endeavors to explain the truth in her column, THE TRUTH ABOUT LITTLE AUDREY Her column provides effective, vital insights into our faith and ways of fulfilling God's Will every day in every way. You can visit Sr. Lucy at her web site for Heart of Mary Ministry at http://www.heartofmaryministry.com

80. University Of Miami School Of Medicine - Glossary - Akinetic For example, a person in coma is akinetic. For another example, akineticmutism is a condition in which a person is both mute and akinetic. http://www.med.miami.edu/patients/glossary/art.asp?articlekey=6989

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