Organic mental disorders: akinetic mutism: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Organic mental disorders: akinetic mutism

Sample item

After an anterior cerebral artery infarct, a 60-year-old man lies with eyes open, tracks the examiner with his gaze, but does not speak or move spontaneously. He responds with a few words when strongly stimulated. Vertical eye movements are normal. Which diagnosis fits best?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Akinetic mutism

Akinetic mutism results from bilateral medial frontal or anterior cingulate damage, leaving the patient awake and apparently attentive but without drive to speak or move. Locked-in patients have pontine damage with preserved awareness and cognition but cannot move except for vertical eye movements and blinking.

Option by option

  • A. Akinetic mutism (correct)

    Correct. A lack of spontaneous speech and movement with preserved tracking after an anterior cerebral lesion is akinetic mutism.

  • B. Catatonic stupor

    Catatonic stupor occurs in psychiatric or medical illness with signs such as posturing and negativism, and the lesion here is structural.

  • C. Locked-in syndrome

    Locked-in syndrome results from a pontine lesion with quadriplegia and communication by vertical eye movements.

  • D. Persistent vegetative state

    A vegetative state has sleep-wake cycles without awareness, and tracking is absent.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, Akinetic mutism. Akinetic mutism results from bilateral medial frontal or anterior cingulate damage, leaving the patient awake and apparently attentive but without drive to speak or move.

Why is "Catatonic stupor" not the answer?

Catatonic stupor occurs in psychiatric or medical illness with signs such as posturing and negativism, and the lesion here is structural.

Why is "Locked-in syndrome" not the answer?

Locked-in syndrome results from a pontine lesion with quadriplegia and communication by vertical eye movements.

Why is "Persistent vegetative state" not the answer?

A vegetative state has sleep-wake cycles without awareness, and tracking is absent.

What concept does this question test?

It tests Organic mental disorders: akinetic mutism in Psychiatry. Locked-in patients have pontine damage with preserved awareness and cognition but cannot move except for vertical eye movements and blinking.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Organic mental disorders: akinetic mutism?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.