Akinetic mutism cases due to bilateral anterior  cerebral artery infarct

Gülsüm  Çomruk; Fatih Demir; Aylin  Akçalı

doi:10.5152/EurJTher.2017.06071

Authors

Gülsüm Çomruk Department of Neurology, Gaziantep University, School of Medicine
Fatih Demir Clinic of Neurology, Şehitkamil State Hospital
Aylin Akçalı Department of Neurology, Gaziantep University, School of Medicine

DOI:

https://doi.org/10.5152/EurJTher.2017.06071

Keywords:

Akinetic mutism, bilateral anterior cerebral artery territory infarct, epileptic seizure

Abstract

Akinetic mutism is a clinical status from the bilateral lesion of nucleus caudatus or anterior cingulate gyrus. Although voluntary motions, speech, and emotional responses are completely gone, the patient may be awake with eyes opened. A 54-year-old man was brought to the emergency clinic with complaints of meaningless stares and inability to speak and walk. On neurological examination, the patient was unresponsive, although he looked awake. The tonus was increased on all extremities, especially on the left arm and leg. On his follow-up, involuntary tiny motions around his mouth were observed. Bilateral anterior cerebral artery infarct was observed on diffusion-weighted magnetic resonance imaging. This case, which may be distinguished from psychiatric charts in clinical practice, is considered to be presented as akinetic mutism due to a rare bilateral ACA infarct.

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