Abstract
LOSS of consciousness in a patient who cannot be aroused must be differentiated from psychogenic coma, akinetic mutism and the "locked-in" syndrome. Akinetic mutism is a prolonged state of relative immobility and silence; the patient may appear awake and may visually track the examiner around the room. Neurologic examination and the occasional occurrence of complex motor activity and speech indicate that this behavioral disturbance is not due to lesions of the elementary motor and speech areas. Bilateral discrete lesions of the rostral brain-stem or basomedian frontal regions may result in this syndrome.1 In the "locked-in" syndrome intact consciousness is concealed . . .
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