Apathy Syndromes

Patients with apathy demonstrate a lack of interest not only in their usual interests and hobbies but also in routine daily activities. Apathy may arise from unilateral or bilateral lesions of the caudate nuclei, bilateral lesions in the lenticular nuclei, or frontal lobe lesions. Apathy is a common aspect of Parkinson's disease and progressive supranuclear palsy and can be difficult to distinguish from depression. Bilateral cingulate lesions can produce akinetic mutism and abulia, but these lesions are not necessarily symmetrical, and one can be cortical while the other is subcortical. Abulia can cause mutism and is characterized by a general slowing of behavior and lowered activity. Patients with abulia show little spontaneous motor or speech activity and may at times fail to respond for minutes or at all to questions or commands. If they occur at all, the responses

are slow and apathetic. Akinetic mutism is an extreme form of abulia, in which patients appear to be awake and may attend to their surroundings but demonstrate no spontaneous motor and verbal responses. These patients may respond intermittently to noxious stimuli and may be doubly incontinent. All of these signs are related to supplementary motor area damage and can be seen with lesions anywhere in the ascending dopaminergic pathways. In these settings, primitive reflexes such as sucking and rooting may also emerge, but if the motor cortex is unaffected, the remainder of the examination may be unremarkable.

Headache Happiness

Headache Happiness

Headache Happiness! Stop Your Headache BEFORE IT STARTS. How To Get Rid Of Your Headache BEFORE It Starts! The pain can be AGONIZING Headaches can stop you from doing all the things you love. Seeing friends, playing with the kids... even trying to watch your favorite television shows. And just think of how unwelcome headaches are while you're trying to work.

Get My Free Ebook

Post a comment