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Acute mutism: a useful lesson.

Melissa Maguire1, Osheik Seidi, Mark Baker

  • 1Department of Neurology, Sunderland Royal Hospital, Sunderland, UK. maguirem@doctors.org.uk

Emergency Medicine Journal : EMJ
|July 28, 2010
PubMed
Summary

Acute mutism can be a symptom of Broca's aphasia, not depression. Early recognition of frontal lobe infarcts is crucial for diagnosis and treatment.

Area of Science:

  • Neurology
  • Psychiatry
  • Neuroscience

Background:

  • Broca's aphasia, a language disorder, can present with mutism.
  • Mutism in patients with psychiatric history may be misdiagnosed as depression.

Observation:

  • A patient with a history of substance abuse presented with acute mutism.
  • The patient was initially suspected of having a depressive illness.

Findings:

  • The patient sustained an infarct (stroke) in the dorsolateral frontal cortex.
  • This neurological event explained the acute mutism.

Implications:

  • Recognizing this presentation aids in the early diagnosis of Broca's aphasia.
  • Prompt diagnosis facilitates timely and appropriate treatment for neurological conditions.

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