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Post-stroke mutism

Consultant Neurologist, Cognitive Function Clinic, The Walton Centre for Neurology and Neurosurgery, Lower Lane, Fazakerley, Liverpool L9 7LJ, UK; a.larner@thewaltoncentre.nhs.uk

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Neurologically unexplained symptoms are not unusual. In my clinical practice, most patients thus labelled do not appear (to me) to have "neurological disease" unless affective disorders be classified as neurological rather than psychological. Sometimes, however, unequivocally "neurological" disorders may have unexplained symptoms and signs. This may be particularly poignant, even galling, when the patient involved happens to be a member of the neurologist’s family.

In March 2001, my father, a 78 year old, right handed, insulin-requiring diabetic, had a stroke. From my mother’s account, this came on one morning after breakfast. Sitting on the bed, he slumped forward and she had to help him to the floor. She wondered if he was having a hypoglycaemic attack but thought it unlikely, and fingerprick blood sugar was normal. The general practitioner attended promptly; he anticipated improvement, but said to call again if my father’s condition deteriorated. A neighbour, summoned to help get . . . [Full text of this article]