Encyclopedia of Clinical Neuropsychology

2018 Edition
| Editors: Jeffrey S. Kreutzer, John DeLuca, Bruce Caplan

Akinetic Mutism

  • Michael S. MegaEmail author
Reference work entry
DOI: https://doi.org/10.1007/978-3-319-57111-9_1876


A spectrum of motivational impairment has abulia at one end and akinetic mutism at the other. Coma vigil is not akinetic mutism; it arises when a comatose patient regains the sleep-wake cycle, eyes open during the day and closed during sleep at night, usually after 2 weeks of a brain lesion that produces irreversible coma. Coma vigil is also referred to as a persistent vegetative state. When brain lesions disconnect all descending motor output but preserve conscious awareness the patient is said to be locked in. In akinetic mutism, patients still respond to their internal and external environment – and thus are not in coma, and they are not locked in since they can accomplish motor output, given sufficient motivation.

Short Description or Definition

The fully formed akinetic mute state usually results from bilateral anterior cingulate lesions (Fig. 1). Patients are profoundly apathetic, incontinent, and akinetic. They do not initiate eating or drinking and if speech occurs,...
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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Center for Cognitive HealthPortlandUSA