Mutism in the Older Adult

Nages Nagaratnam, MD, FRCP, FRACP, FRCPA, FACC; Gowrie Pavan, MBBS, FRAGP


Geriatrics and Aging. 2005;8(8):61-68. 

In This Article

Chronic Neurological Disorders

There are a number of chronic neurological disorders that exhibit pseudobulbar or bulbar palsy (dysarthria and dysphagia) and in which mutism supervenes. In pseudobulbar palsy there are bilateral lesions following cerebrovascular incidents resulting in involvement of the corticobulbar pathways; this causes dysarthria, dysphagia, and slow tongue movements together with corticospinal tract signs. Progressive supranuclear palsy (PSP) is a nonfamilial progressive disorder of gait and balance with supranuclear gaze palsy, bradykinesia, and pseudobulbar palsy. Motor neurone disease (progressive bulbar palsy and amyotrophic lateral sclerosis) is characterized by progressive degeneration of the corticospinal tracts, anterior horn cells, and/or bulbar motor nuclei. In Parkinson's disease the speech is characterised by hypophonia, dysarthria, reduced variability of rhythm and pitch, and, finally, unintelligible speech.


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