Mutism

Introduction Mutation is a disorder in which there is no speech activity. Anyone asks but never says a word. Some patients can express their meaning by writing, acting, etc. There are no organic lesions in the speech organs, and mental development is also barrier-free.

Cause

Found in schizophrenia tension, psychogenic stupor, depressive stupor, organic stupor state and snoring. As a special symptom of silence, it means that the speech organs have no organic disease, and the intellectual development is also barrier-free and silent. Selective mutism often occurs in children with sensitive, timid, and secluded personality. Parents often suffer from excessive love, protection, illness due to initial leave of the family, and environmental changes. Some cases may be related to genetic factors. Patients with rickets, affective disorders, and schizophrenia may also experience silent symptoms.

an examination

Related inspection

Brain CT examination EEG examination

The patient has no aphasia, the function of the vocal organ is normal, only the psychomotor inhibition or the functional inhibition of the speech motor area cortex. In the examination, it is necessary to check the situation of the relevant nervous system, and also need to check the blood electrolyte, blood gas analysis, brain CT, EEG and so on. If necessary, it is necessary to cooperate with the psychiatrist's examination.

Differential diagnosis

(a) selective mutism (elective mutism) "silent" high selectivity is the characteristics of this disease. The child's mental development is normal, and the IQ of the Wechschild Intelligence Test is 70 or 70. The onset is mostly 3 to 7 years old, more common in women, mostly sensitive and shy personality. There is no abnormality in the nervous system examination and there are no other mental or physical disorders.

(2) Hysterical mutism can sometimes occur simultaneously with rickets. If there is no stupidity, only the movements of silence, writing, gestures, etc. are very agile, and facial expressions are also very lively. Silent performance, like other clinical symptoms, has the characteristics of seizures, sudden recovery, and easy acceptance of cues.

(c) Catatonic mutism patients with silent, or fragmented language, accompanied by rejection, violations, stupor, waxy flexion, impulsive and other symptoms. The patient has a clear consciousness, no intelligence deficit, and lack of self-awareness. The diagnosis should be based on a typical medical history of schizophrenia or a typical symptom of a stress disorder.

(4) Delusinonal mutism system paranoia and delusional schizophrenia can be silenced. It is common for the surrounding people to disagree with the delusional content of the patient, and refuse to talk to the surrounding people and to remain silent because the hallucinations or delusions of the content "command" the patient. The patient has no violations, impulsiveness, or stiffness.

(5) Melancholiac mutism Depression can be expressed as stupor or muttering, the patient's face is mournful, sometimes accompanied by paroxysmal anxiety, and the severe condition is absolutely silent. Although the performance of chronic cases is like "dementia", the medical history has early pessimistic delusions and emotional depression, and can be restored after electroconvulsive treatment.

(6) malingering mutism (malingering mutism) There is no disease in simple scams, completely disguised as "no language"; expansionary scams have certain real conditions, but silence is not the performance of the original condition.

(7) Others

Some organic diseases may also have mutism at different stages of the disease, such as severe Parkinson's disease, cerebrovascular disease, cerebral hypoxia sequelae, and bilateral hysterectomy. The corresponding clinical manifestations, medical history and laboratory tests can be diagnosed.

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