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Japanese

THALAMIC DEMENTIA AND AKINETIC MUTISM Hisanobu Kaiya 1 , Tsuyoshi Yoshimura 1 , Tsuyoshi Iwata 1 , Iwao Moriuchi 1 , Kenji Ikeda 1 1Department of Neuropsychiatry, Gifu University School of Medicine pp.75-79
Published Date 1978/1/1
DOI https://doi.org/10.11477/mf.1406204189
  • Abstract
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A clinico-pathological study on an unclassified case of presenile degeneration of the CNS was reported, which showed dementia and terminal akinetic mutism.

Memory disturbance, impaired judgement and irritability were manifested in a 61-year-old female and akinetic mutism gradually predominated. In this condition continuous hyperthermia, sweating and incontinence were observed, while deglutition and mastication were well preserved. Neuro-logically, rigidity of the upper limbs and hypotonic lower limbs in a characteristic contracted posture, hand tremor, oil face and Babinski sign were re-vealed. Neuronal loss and reactive gliosis were found in the globus pallidus, especially, in the inner segment, and in the zona compacta of the substantia nigra. The mediodorsal nucleus, the centromedian nucleus, nucl. parafascicularis and the anterior nucleus were severely affected in the thalamus. The reticular formation of the medulla oblongata and the pons were involved with eminent gliosis. Anatomical and pathophysiological consid-eration suggested that lesions not only in the thalamus but also in the globus pallidus play a great role for manifestation of akinetic mutism. In the literature as well as in the present case, thalamic dementia develops often into akinetic mutism and pathological localization pattern in the thalamus of these two conditions has a remarkable resemblance. These evidences show that thalamic dedentia and akinetic mutism may occur in the same pathomorphological substratum. The differ-ence between these clinical manifestations seems to relate to the extension and tempo of the patho-logical process. One must also consider involve-ment of the reticular formation, i. e., the center of consciousness, in akinetic mutism.


Copyright © 1978, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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