Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Mutism”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed1991

Mutism after removal of a vermian medulloblastoma: cerebellar mutism.

A case of mutism after removal of a vermian medulloblastoma from a 4-year-old girl is reported. Postoperatively, the patient was mute without disturbance of consciousness, language comprehension, or lower cranial nerve function. Computed tomography scans demonstrated no abnormal findings except for the surgical lesion in the posterior fossa. The mutism lasted for 78 days, followed by a period of dysarthria, but she gradually became fluent. The mechanism of "cerebellar mutism" is briefly discussed.

Cerebellar Neoplasms↗
PubMed1992

[Hereditary unilateral deaf-mutism as a variable manifestation of bilateral deaf-mutism or hearing loss].

A total of 2,519 patients with bilateral severe congenital deafness (deaf-mutism) from Central Switzerland were recorded during the period between 1834 to 1979. More recently, 31 persons with unilateral severe deafness were examined. By constructing genealogical charts going back to the 17th century, at least ten of these unilaterally deaf persons were shown to be related to patients with bilateral deafness (pedigrees I-IV). Some of them exhibited a more or less marked Klein- Waardenburg syndrome. The unilateral deafness of those patients was inherited and not acquired. Congenital unilateral deafness may be understood to be the result of the broad variability of the expressivity of acoustic defects.

Deafness↗
PubMed1992

Elective mutism as a variant of social phobia.

To examine the relationship between the syndromes of elective mutism and social phobia, a case of elective mutism associated with social phobia in a 12-year-old girl is presented, and the clinical literature regarding the syndrome of elective mutism is reviewed. Elective mutism or reluctance to speak in unfamiliar social situations may be a symptom of social phobia. Social anxiety is a nearly universal characteristic of children manifesting the syndrome of elective mutism. Elective mutism may respond to treatment with medications that also are effective in the treatment of social phobia. Elective mutism may be a manifestation of social phobia rather than a separate diagnostic syndrome. Pharmacologic treatment may be effective.

Child↗
PubMed1991

Mechanism of mutism following the transcallosal approach to the ventricles.

Transient mutism has been known as a common manifestation following callosotomy for medically intractable epilepsy, but its cause has not been clearly elucidated. In this paper, we report three cases of mutism following a transcallosal approach to tumours in the lateral and third ventricles and retrospectively analyze the surgical, neurological and radiological features which may suggest the cause of this type of mutism. Mutism may be a result of division of the corpus callosum. Suppression of the limbic system caused by lesions in the anterior cingulate gyrus, septum pellucidum, and fornix may have been of importance in at least two of these three cases. Impairments of the supplementary motor cortex, thalamus and basal ganglia may also be factors reducing speech production. The mechanism of such transient mutism seems to be a complex of two or more of these factors, and their combinations may be different from one case to the other.

Adult↗
PubMed1975

[Akinetic mutism and bicingular softening. 3 anatomo-clinical cases].

The authors describe three pathological cases of akinetic mutism with, as a common basic lesion, bilateral infarction of the cingulate gyrus secondary to aneurysm of the anterior communicating artery (case n degrees 1), to a huge olfactory meningioma (case n degrees 2), both operated on, and to atheromatous occlusion of the anterior cerebral arterial system (case n degrees 3). These three cases enable a variety of "anterior and waking" akinetic mutism to be described which is unusual enough to be compared with other mesencephalic and diencephalic aspects of this syndrome. It is in fact an akinetic mutism characterized by: a certain dissociation in its non-response to various stimuli, a particularly marked appearance of wakefulness when day-time alertness is considered, conservation of the waking-sleeping rhythm, perception and reaction unpredictable and paradoxical in both degree and quality, complete absence of any spontaneous verbal communication in contrast to relative break-down of solicited communication which is infrequent, uncertain and unresponsive to the usual methods of stimulation, without any possibility of a code. In addition, there is a remarkable mimic and segmental general akinesia, resistant to the usual nociceptive stimuli, but sensitive to slight excitation of the manual and oral zones. Besides this special akinetic mutism, there are variously systematised signs, mostly asymmetrical, indicating lesion of the cortico-sub-cortical frontal structures bordering on the gyrus cinguli. This unusual behaviour pattern corresponds in these three cases to extensive anterior bilateral ischemic lesions of the cingulate gyrus regularly associated with bilateral infarctions confined to the medial aspect of F1 in the superficial territory of the two anterior cerebral arteries, to possible neurosurgical changes (ablation of the right frontal pole) and to compressive or ischaemic lesions of the gyrus rectus. These exclusively cortico-sub-cortical associated lesions are in contrast with the remarkably intact caudate nuclei, the pallidal, thalamic, hypothalamic and septal formations and the anterior pillars of the fornix. These findings compared with the results of experimental research carried out by M. Kennard, help, if help is needed, to resolve the apparent contradictions between the effects of therapeutic cingulectomies or cingulotomies and the scanty pathological data already available in cerebral vascular pathology.

Adult↗
PubMed1992

Acquired mutism: physiopathy and assessment.

The speechless patient presents a unique challenge to the clinician working with neurologically impaired adults. Acquired speechlessness, or mutism, has been associated with a variety of clinical states and syndromes after damage to central and peripheral nervous system structures. The intent of this paper is to summarize the reported states and syndromes associated with acquired mutism (eg, persistent vegetative state, akinesia), and to organize this information in a framework for clinical assessment of the speechless patient. For the purpose of discussion, speech production is divided into five interrelated processes: arousal; cognitive processing; affect and drive; motor initiation, planning, programming, and coordination; and execution of movement. Disorders characterized by mutism are classified according to the process or processes of speech production that primarily are affected. Each subtype of acquired mutism is characterized by a cluster of neurologic signs, which has been incorporated into a decision-making framework for use in a clinical setting.

Affect↗
PubMed1992

Controlled investigation of the amobarbital interview for catatonic mutism.

OBJECTIVE: Clinical reports over the last 60 years suggest that the amobarbital interview is effective in relieving catatonic symptoms. This has never been substantiated with methodologically sound trials. The authors postulated that a randomized blind comparison of intravenous amobarbital and saline would demonstrate the superiority of amobarbital in relieving catatonic mutism. METHOD: The subjects were 20 inpatients with catatonic mutism. They were randomly assigned to either saline (N = 10) or a 5% amobarbital solution (N = 10), and the infusions were administered intravenously at a rate of 1 cc/min or less over 10 minutes by a blinded physician. A second blinded physician administered a semistructured interview during the infusion to control for the effect of suggestion. A third blinded physician rated patient responsiveness, reactivity, and arousal. Any patient who was unresponsive to the initial infusion was crossed over to the other infusion. Interviews were videotaped for determination of interrater reliability. RESULTS: In the initial infusions, six of 10 patients responded to amobarbital and zero of 10 responded to saline. Four of the saline nonresponders responded when given amobarbital. Response was evident by the 4th minute of the amobarbital infusion. Interrater reliability was high. The responders and nonresponders differed significantly in the variance of the weight-adjusted amobarbital dose, and the responders tended to be older and female. CONCLUSIONS: Intravenous amobarbital is superior to saline in relieving catatonic mutism, although only 50% of these patients responded. The nonresponders were distinguished from the responders by a greater variance in the weight-adjusted dose of amobarbital.

Adult↗
PubMed1991

Elective mutism: origins in stranger anxiety and selective attention.

Through a focus on the events of early infancy, the author interprets elective mutism on the basis of the infant's responses to discrepancies from expected stimuli. Initially, the child's silence derives from a "freezing" of action when exposed to perceived danger. Subsequently, aberrant or fearful stimuli are minimized by the child's apparent unresponsiveness. Through identification with the parent, the child imbues elective mutism with information value as a pause to signal impending communication. Mutism later represents an identification that is displaced from the parent to "stranger" adults.

Attention↗
PubMedDate not supplied

[Post-traumatic mutism. A report of five cases (author's transl)].

After a review of current concepts about post-traumatic mutism, the authors describe five patients with this unusual symptom. The study extends on a long follow-up period. Differential diagnosis and possible neurological and psychopathological factors are discussed. Analysis of their personal observations leads the authors to think that there is a relationship between the length of coma and the duration of mutism. Frontal and/or bilateral lesions seem to be more likely to produce post-traumatic mutism, as does the existence of emotional disturbances or depressive symptoms in past history.

Adolescent↗
PubMed1992

Akinetic mutism in bilateral necrotizing leucoencephalopathy after radiation and chemotherapy: electrophysiological and autopsy findings.

In a patient with akinetic mutism, extensive circumscribed bilateral lesions in the precentral part of the centrum semiovale, due to delayed necrotizing leucoencephalopathy after combined intravenous polychemotherapy and radiation, were found at autopsy. CT and somatosensory evoked potentials were normal and a slow alpha rhythm was present, but there was a lack of EEG desynchronization. Akinetic mutism and the loss of desynchronization in this case are thought to result from interrupted thalamofrontal and extrathalamic reticulofrontal projections and the disconnection of the anterior limbic cortex.

Adult↗
PubMed1992

Mutism after cerebellar medulloblastoma surgery.

The case of a 9-year-old boy is presented, who developed transient mutism after removal of a medulloblastoma in the region of the cerebellar vermis. The mutism disappeared within 6 months. Neither reduction of consciousness nor disturbances of caudal cranial nerves or phonation ever appeared. The case is discussed with regard to its phenomenology, pathogenesis, and etiology, corresponding case reports are also taken into consideration.

Brain Edema↗
PubMed1976

[Mutism as permanent catatonic condition].

The history of a case of mutism, where the patient had been silent for more than twenty-five years, caused by the author to study and discuss this relatively infrequent catatonic symptom which is a type of schizophrenia, with frequent references being made to the results of psychiatric studies made by authors ranging from Kahlbaum to Leonhard. Permanent mutism as a possible phenomenal form was logically classified, by Leonhard, as a type of mannered catatonia.

Aged↗
PubMedDate not supplied

[Characteristics of the dermatoglyphics of the hand in congenital deaf-mutism].

Differences in a number of dermatoglyphic signs in patients with endogenous forms of the disease were found when analysing dermatoglyphics among 535 patients with congenital deaf-mutism. These differences may be of certain significance for differentiation between exogenous and endogenous forms of deaf-mutism, that is of great importance for a medico-genetical consultation with respect to progeny prognosis.

Adolescent↗
PubMed1991

Transient cerebellar mutism after posterior cranial fossa surgery in an adult. Case report and review of the literature.

Transient mutism, without disorders of consciousness or cranial nerve deficits, arising after surgical operations on the posterior cranial fossa is a recently described entity. To date 22 cases have been reported, to which we add the present case (the first report of the syndrome in an adult). We review the salient features of the syndrome in the light of the published cases and speculate on the underlying physiopathology.

Cerebellar Diseases↗
PubMed1992

A study of the effectiveness of a specific treatment for elective mutism.

Elective mutism represents a relatively rare clinical syndrome in which children with normal verbal capabilities totally refuse to speak in select settings for prolonged periods of time. It is often described as particularly treatment resistant. This study describes 20 strictly diagnosed elective mutes treated, using the Hawthorn Center approach. As found in other studies, most of the elective mutes in this sample (90%) were described as controlling, negative, or oppositional, and a high rate (50%) of maternal-child overenmeshment was found. Treatment outcome using the Hawthorn Center approach was found to be at least fair for all cases and excellent for 85%.

Child↗
PubMed1979

Elective mutism.

Eleven children who had received a diagnosis of elective mutism upon admission to the children's psychiatric clinic, were followed up 8--18 years later. The average age upon admission was 9 1/2 years, and at the time of follow-up, 23 years. Nine of the children came from homes with a strong familial shyness and reservation, and eight lived in social isolation. Six were particularly overprotected. Six came from discordant family constellations. All were diagnosed neurotic, eight specified as compulsion-neurosis. All were of normal intelligence. Six children received extensive individual psychotherapy (four upon admission to the clinic, two by way of out-patient treatment). We were unable to offer similar treatment to the remaining five. During the course of treatment three of the admitted patients improved, the fourth and the two ambulatory patients remained unchanged after up to 4 years of therapy. The follow-up study showed the three unchanged patients and the five who had received treatment, now were cured of the symptom; improvement took place in connection with a change of environment. The five who had not received treatment were better adjusted than those who had been separated from home for several years, at a vulnerable age. The importance of early prophylactic intervention is emphasized.

Adult↗
PubMed1975

A syndrome of depression and mutism in the Oglala Sioux.

The wacinko syndrome in the Oglala Sioux varies from a nonclinical reaction to pathological degrees of anger, pouting, withdrawal, depression, psychomotor retardation, mutism, immobility, and even to suicide. Although indigenous proctitioners recognize the syndrome as a distinctive disorder, it has not been described by non-Indian practitioners. The author presents a case report and suggests that most cases are diagnosable as reactive depressive illness.

Adjustment Disorders↗