Alert, but mute and motionless: a case of acute akinetic mutism

By Anna Shavers

In a recent case study, Varun Jain, M.D. and Bhavana Patel, D.O. from the Norman Fixel Institute for Neurological Diseases at UF Health explore the association between cerebral fat embolism and acute akinetic mutism in a 70-year-old, African-american man diagnosed with hemoglobin sickle cell (SC) disease.

Fat embolism are a common complication of SC disease that occur when fat enters the bloodstream. In the case led by Dr. Jain and Dr. Patel, fat embolism caused by the patient’s SC disease occurred in the brain and triggered acute akinetic mutism.

Acute akinetic mutism is a condition in which a patient is alert but mute (non-verbal), unable to follow commands and does not make any purposeful movements. While fat embolism are common in patients with SC disease, the manifestation of acute akinetic mutism is not widely documented or understood.

“The association between cerebral fat embolism and acute akinetic mutism has never been described before. To identify the changes from the fat embolism in the brain, we had to use a specific type of MRI sequence called susceptibility weighted imaging (SWI). Without SWI, we may have missed the diagnosis,” said Dr. Jain.

The case broadens the understanding of potential complications from SC disease and fat embolisms in relation to causing acute akinetic mutism. Bringing awareness is the first step to ensure proper diagnosis and treatment. 

“Delayed treatment of central nervous system fat embolism has irreversible damage, so sooner the diagnosis – the better it is,” said Dr. Jain.

Read the full in the journal Neurology.