Unique Presentation of Akinetic Mutism and Coexisting Thyroid Storm Relating to Stroke

Akinetic mutism is described in various clinical presentations but typically is defined as a state wherein the patient appears awake but does not move or speak. It can be divided into two different subtypes; the most common subtypes depend on the lesion location, mesencephalic-diencephalic region, a...

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Main Authors: Mohankumar Kurukumbi, Thao Dang, Najeeb Crossley, Alice Esame, Annapurni Jayam-Trouth
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Case Reports in Neurological Medicine
Online Access:http://dx.doi.org/10.1155/2014/320565
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author Mohankumar Kurukumbi
Thao Dang
Najeeb Crossley
Alice Esame
Annapurni Jayam-Trouth
author_facet Mohankumar Kurukumbi
Thao Dang
Najeeb Crossley
Alice Esame
Annapurni Jayam-Trouth
author_sort Mohankumar Kurukumbi
collection DOAJ
description Akinetic mutism is described in various clinical presentations but typically is defined as a state wherein the patient appears awake but does not move or speak. It can be divided into two different subtypes; the most common subtypes depend on the lesion location, mesencephalic-diencephalic region, also called apathetic akinetic mutism (somnolent mutism), and those involving the anterior cingulate gyrus and adjacent frontal lobes called hyperpathic akinetic mutism. The pathway of akinetic mutism is believed to originate from circuits that link the frontal and subcortical structures. This case reports a 48-year-old African American female with bilateral anterior cerebral artery stroke and akinetic mutism with coexisting thyroid storm. This patient with bilateral anterior cerebral artery infarcts presented with characteristics that are typical for akinetic mutism such as having intact eye movements but an inability to respond to auditory or visual commands. With the incidence of bilateral anterior cerebral artery (ACA) ischemic stroke being rare and the incidence of akinetic mutism secondary to ischemic stroke even rarer, we suspect that this patient potentially had a unilateral occlusion of anomalous anterior cerebral vasculature.
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spelling doaj-art-1f8d13f660f94b9eb44f39b9581c3a4d2025-08-20T03:54:34ZengWileyCase Reports in Neurological Medicine2090-66682090-66762014-01-01201410.1155/2014/320565320565Unique Presentation of Akinetic Mutism and Coexisting Thyroid Storm Relating to StrokeMohankumar Kurukumbi0Thao Dang1Najeeb Crossley2Alice Esame3Annapurni Jayam-Trouth4Department of Neurology, Howard University Hospital, 2041 Georgia Avenue, Washington, DC 20060, USADepartment of Neurology, Howard University Hospital, 2041 Georgia Avenue, Washington, DC 20060, USADepartment of Neurology, Howard University Hospital, 2041 Georgia Avenue, Washington, DC 20060, USADepartment of Neurology, Howard University Hospital, 2041 Georgia Avenue, Washington, DC 20060, USADepartment of Neurology, Howard University Hospital, 2041 Georgia Avenue, Washington, DC 20060, USAAkinetic mutism is described in various clinical presentations but typically is defined as a state wherein the patient appears awake but does not move or speak. It can be divided into two different subtypes; the most common subtypes depend on the lesion location, mesencephalic-diencephalic region, also called apathetic akinetic mutism (somnolent mutism), and those involving the anterior cingulate gyrus and adjacent frontal lobes called hyperpathic akinetic mutism. The pathway of akinetic mutism is believed to originate from circuits that link the frontal and subcortical structures. This case reports a 48-year-old African American female with bilateral anterior cerebral artery stroke and akinetic mutism with coexisting thyroid storm. This patient with bilateral anterior cerebral artery infarcts presented with characteristics that are typical for akinetic mutism such as having intact eye movements but an inability to respond to auditory or visual commands. With the incidence of bilateral anterior cerebral artery (ACA) ischemic stroke being rare and the incidence of akinetic mutism secondary to ischemic stroke even rarer, we suspect that this patient potentially had a unilateral occlusion of anomalous anterior cerebral vasculature.http://dx.doi.org/10.1155/2014/320565
spellingShingle Mohankumar Kurukumbi
Thao Dang
Najeeb Crossley
Alice Esame
Annapurni Jayam-Trouth
Unique Presentation of Akinetic Mutism and Coexisting Thyroid Storm Relating to Stroke
Case Reports in Neurological Medicine
title Unique Presentation of Akinetic Mutism and Coexisting Thyroid Storm Relating to Stroke
title_full Unique Presentation of Akinetic Mutism and Coexisting Thyroid Storm Relating to Stroke
title_fullStr Unique Presentation of Akinetic Mutism and Coexisting Thyroid Storm Relating to Stroke
title_full_unstemmed Unique Presentation of Akinetic Mutism and Coexisting Thyroid Storm Relating to Stroke
title_short Unique Presentation of Akinetic Mutism and Coexisting Thyroid Storm Relating to Stroke
title_sort unique presentation of akinetic mutism and coexisting thyroid storm relating to stroke
url http://dx.doi.org/10.1155/2014/320565
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AT najeebcrossley uniquepresentationofakineticmutismandcoexistingthyroidstormrelatingtostroke
AT aliceesame uniquepresentationofakineticmutismandcoexistingthyroidstormrelatingtostroke
AT annapurnijayamtrouth uniquepresentationofakineticmutismandcoexistingthyroidstormrelatingtostroke