Akinetic mutism

Akinetic mutism is a medical condition where patients tend neither to move (akinesia) nor speak (mutism). It is the most extreme disorder of diminished motivation. Akinetic mutism was first described in 1941 as a mental state where patients lack the ability to move or speak.^[1] However, their eyes may follow their observer or be diverted by sound.^[1] Patients lack most motor functions such as speech, facial expressions, and gestures, but demonstrate apparent alertness.^[2] They exhibit reduced activity and slowness, and can speak in whispered monosyllables.^[1][3] Patients often show visual fixation on their examiner, move their eyes in response to an auditory stimulus, or move after often repeated commands.^[1][2] Patients with akinetic mutism are not paralyzed, but lack the will to move.^[1] Many patients describe that as soon as they "will" or attempt a movement, a "counter-will" or "resistance" rises up to meet them.^[4]