Presentation
We present a case of abulia S/P right middle cerebral artery, treated successfully with olanzapine. [ncbi.nlm.nih.gov]
While the patients can have variable presentations including headache, nausea, confusion, seizures, weakness, coma; mood disorders as a part of the presentation has not been reported. [n.neurology.org]
BACKGROUND: While the majority of sports-related concussions present as headache, nausea, dizziness, confusion, and unsteadiness, there are other less common presenting symptoms such as mood disorders and irritability. [neurology.org]
Psychiatrical
- Anhedonia
Abstract Anhedonia and abulia are syndromes often presented as components of various psychiatric and neurological disorders, including depression, schizophrenia, stroke, multiple sclerosis and brain injury. [ncbi.nlm.nih.gov]
However, she denies dysphoria or anhedonia. [mdedge.com]
A preliminary study of apathy in dementia showed that patients with apathy but no depression rarely report anhedonia, suggesting that anhedonia is more characteristic of depression than apathy (SE Starkstein, personal communication). [doi.org]
Her neurological exam was significant for apathy, anhedonia and slowed responses. [n.neurology.org]
See Anhedonia. a·bu·li·a ( ā-bū'lē-ă ) 1. Loss or impairment of the ability to perform voluntary actions or to make decisions. 2. Reduction in speech, movement, thought, and emotional reaction; a common result of bilateral frontal lobe disease. [medical-dictionary.thefreedictionary.com]
- Delusion
Notably, some patients reported adverse effects, including delusions and irritability.54 Although available evidence suggests AChEIs may be the most effective medications for treating apathy in NCDs, methylphenidate has been demonstrated to work faster [mdedge.com]
[…] capacities such as praxis, speech, sense modalities, recognition, and long-term memory. 7 Noncognitive symptoms are common: 73% of patients in a Japanese study reported significant apathy, and 10% to 25% of patients also reported positive symptoms of delusions [neuro.psychiatryonline.org]
Symptoms of apathy such as restricted affect, low social drive and poverty of speech may be caused by multiple factors, such as neuroleptic drugs, the psychotic experience itself (eg, being unable to work because of auditory hallucinations or paranoid delusions [doi.org]
- Psychomotor Retardation
The clinical picture corresponds most accurately to the neurological syndrome of abulia, which is an important differential diagnosis of depression with psychomotor retardation. [ncbi.nlm.nih.gov]
Cambridge: CUP, 1995: 182-187 Cross References Akinetic mutism; Apathy; Bradyphrenia; Catatonia; Frontal lobe syndromes; Psychomotor retardation [minclinic.ru]
- Low Self-Esteem
In general, the apathy, low self-esteem and emotional inhibition act as obstacles to improvement. 1. Celebrate small accomplishments For people with abulia, anything, no matter how small it may seem, is a difficult task. [steptohealth.com]
- Abnormal Behavior
This is supported by the research evidence of increased frontal cerebral perfusion after shunting. 4, 5 Catatonia and NPH Catatonia is a syndrome of abnormal behaviors and movements due to neuromedical insults that can present in either retarded or excited [neuro.psychiatryonline.org]
Neurologic
- Stroke
stroke related psychiatric disorders, and other rare causes of stroke disorder. * A comprehensive source that thoroughly examines the neurological manifestations of stroke * A guide to highly studied topics, including stroke complications, syndromes [books.google.ro]
We present resting state functional connectivity MRI (fcMRI) data from an individual who suffered a stroke leading to abulia. [ncbi.nlm.nih.gov]
It is estimated that approximately 20% to 25% of stroke survivors experience apathy or abulia. When abulia results from a sudden event, such as a stroke, it may become apparent during or after stroke recovery. [verywellhealth.com]
Brain injuries or Brain damage which cause personality change, such as dementing illnesses, trauma, or intracerebral hemorrhage (stroke). Especially, the stroke causing diffuse injury to the right hemisphere. [healthybugz.com]
- Confusion
They’re not to be confused with the presence of abulia. Abulia may be more common than once thought, as it tends to be a widely underdiagnosed condition, often confused with other diseases or disorders. [healthline.com]
This is not to be confused with simple indecisiveness, as abulia is physiological. Aboulia, however, can be synonomous with extreme indecisiveness. [house.fandom.com]
It may be confused with the psychomotor retardation of depression and is sometimes labeled as "pseudodepression." More plausibly, abulia has been thought of as a minor or partial form of akinetic mutism. [minclinic.ru]
- Seizure
Krishnamoorthy, ES ; Trimble, MR ; (2002) Abulia in a seizure-free patient with frontal lobe epilepsy. In: Schmidt, D and Schachter, SC, (eds.) 110 puzzling cases of epilepsy. (pp. 327-330). Martin Dunitz: London. [discovery.ucl.ac.uk]
While the patients can have variable presentations including headache, nausea, confusion, seizures, weakness, coma; mood disorders as a part of the presentation has not been reported. [n.neurology.org]
Ennapadam S Krishnamoorthy and Michael R Trimble, Abulia in a Seizure-Free Patient with Frontal Lobe Epilepsy, Puzzling Cases of Epilepsy, 10.1016/B978-0-12-374005-2.00065-X, (263-266), (2008). Daniel A. [doi.org]
This may mean controlling seizures or headaches, arranging physical or cognitive rehabilitation for cognitive and sensorimotor loss, or ensuring optimal hearing, vision and speech. [globalscienceresearchjournals.org]
This may mean controlling seizures or headaches, arranging physical or cognitive rehabilitation for cognitive and sensorimotor loss, or ensuring optimal hearing, vision, and speech. [healthybugz.com]
- Agitation
At the beginning of the study the focus was on abulia, but it was natural that sooner or later the contrasting state of behavioral hyperactivity or agitation would have to come under equal scrutiny. [ncbi.nlm.nih.gov]
The only literature describing a similar post-tap agitation is C. [neuro.psychiatryonline.org]
Richmond Agitation-Sedation Scale 6 score is 0 (alert and calm) and test of sustained attention (‘Vigilant A’) is intact (ie, based on the Confusion Assessment Method for the Intensive Care Unit [CAM-ICU], 7 Ms. E does not have delirium). [mdedge.com]
- Neglect
Personal hygiene may be neglected or abandoned. Emotional dullness: indifference to or difficulty responding to the situations they’re experiencing. Slow movements or motor inhibition. [steptohealth.com]
[…] the etiology of abulia: Anterior cingulate cortex:[3] Most common, produced by anterior cerebral artery infarction and produces abulia minor Unilateral anterior cerebral artery lesions produce transient abulia often associated with contralateral motor neglect [ncbi.nlm.nih.gov]
Dysdiadochokinesia Intention tremor ) medial ( Cerebellar ataxia ) Basal ganglia Chorea Dystonia Parkinson's disease Cortex ACA syndrome MCA syndrome PCA syndrome frontal lobe : Expressive aphasia Aboulia parietal lobe : Receptive aphasia Hemispatial neglect [en.wikipedia.org]
Treatment
There are reports of successful treatment of akinetic mutism, the most severe form of abulia, with bromocriptine. [ncbi.nlm.nih.gov]
Treatment team Treatment of abulia is usually part of a program of general rehabilitation for the symptoms accompanying the underlying condition. A neurologist or psychiatrist may lead a treatment team. [encyclopedia.com]
Treatment Most of the current treatments for abulia are pharmacological, including the use of antidepressants. Commentary Open Access However, treatment with antidepressants has not always been successful, opening the door to alternative treatments. [globalscienceresearchjournals.org]
Prognosis
Prognosis The prognosis of abulia depends on the prognosis of the underlying condition. Resources BOOKS Friedman, Joseph H. "Mood, Emotion, and Thought." In Textbook of Clinical Neurology, edited by Christopher G. Goetz. Philadelphia: W. B. [encyclopedia.com]
Prognosis The prognosis depends on the underlying condition causing abulia. [ncbi.nlm.nih.gov]
Google Scholar Giroud M, Lemesle M, Madinier G, Billiar T, Dumas R: Unilateral lenticular infarcts: radiological and clinical syndromes, aetiology and prognosis. JNNP. 1997, 63: 611-615. [bmcneurol.biomedcentral.com]
Etiology
It can have several different etiologies, many of which require further evaluation and treatment. [ncbi.nlm.nih.gov]
Catatonia in NPH may be underreported for several reasons: the biomechanical etiology of NPH suggests a mechanical treatment, the removal of CSF, rather than medicinal or electroconvulsive therapies as for catatonia; and practitioners in neurological [neuro.psychiatryonline.org]
Epidemiology
[…] infarct, and ruptured anterior communicating artery aneurysms Closed head injury Parkinson disease Other causes of frontal lobe disease: tumor, abscess, frontal lobotomy Metabolic and electrolyte disorders: hypoxia, hypoglycemia, hepatic encephalopathy Epidemiology [ncbi.nlm.nih.gov]
However, it is not seen as an independent disease and is not placed in the DSM, therefore the epidemiology is unknown. [yourbrain.health]
Other relevant issues, such as epidemiology, demographic and clinical correlates, and putative mechanism of apathy in specific neuropsychiatric conditions, will not be directly addressed. [doi.org]
Pathophysiology
The pathophysiology of impaired cerebral blood flow causing neuropsychiatric symptoms in polycythaemia is discussed. [ncbi.nlm.nih.gov]
Each entry includes: a definition of the sign; a brief account of the clinical technique required to elicit the sign; a description of the other signs which may accompany the index sign; an explanation of pathophysiological and/or pharmacological background [books.google.ro]
Although not fully elucidated, the pathophysiology of abulia, apathy, and akinetic mutism is thought to be related to multiple neurotransmitters--especially dopamine--involved in the cortico-striatalpallidal-thalamic network. [freethesaurus.com]
Prevention
[…] manifestations of stroke * A guide to highly studied topics, including stroke complications, syndromes, and stroke related psychiatric disorders * A better understanding of the pathophysiological basis of strokes that will help practitioners better diagnose, prevent [books.google.ro]
Prevention of Abulia Abulia does not have a preference. It can happen to anyone, of any race, gender or age without a warning. It can be prevented in children and adolescents by allowing them to pick up interest in a hobby, specifically music! [yourbrain.health]
Get to Know about Mesothelioma-treatment-symptoms-causes-prevention . [healthybugz.com]
To date, there is no way to prevent abulia, and the disorder can affect any individual irrespective of age, race, gender, or ethnicity. Neuroscience and rehabilitation nurses work with occupational therapists and physicians to treat these patients. [ncbi.nlm.nih.gov]