Aboulia

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [3]

Overview

Aboulia or Abulia (from the Greek "αβουλία", meaning "non-will"), in neurology, refers to a lack of will or initiative. The patient is unable to act or make decisions independently. It may range in severity from subtle to overwhelming.

Pathophysiology

Abulia may result from a variety of brain injuries which cause personality change, such as dementing illnesses, trauma, or intracerebral hemorrhage (stroke), especially stroke causing diffuse injury to the right hemisphere. Abulia has also been associated with amphetamine withdrawal.[1]It may complicate rehabilitation when a stroke patient is uninterested in performing tasks like walking despite being capable of doing so. It should be differentiated from apraxia, when a brain injured patient has impairment in comprehending the movements necessary to perform a motor task despite not having any paralysis that prevents performing the task; that condition can also result in lack of initiation of activity.

Especially in patients with progressive dementia, it may affect feeding. Patients may continue to chew or hold food in their mouths for hours without swallowing it. The behavior may be most evident after these patients have eaten part of their meals and no longer have strong appetites. Caregivers can use sweet or salty flavored foods later in meals to provide interest and increase oral intake, but must always clear the mouth of food after each meal.

Causes

Common Causes

Causes by Organ System

Cardiovascular Huntington's disease, amphetamine withdrawal, Parkinson's disease, traumatic brain injury
Chemical / poisoning No underlying causes
Dermatologic No underlying causes
Drug Side Effect Amphetamine withdrawal
Ear Nose Throat traumatic brain injury
Endocrine Huntington's disease
Environmental No underlying causes
Gastroenterologic Hydrocephalus, intracerebral hemorrhage, traumatic brain injury, multiple sclerosis, progressive supranuclear palsy, Parkinson's disease
Genetic Huntington's disease
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease No underlying causes
Musculoskeletal / Ortho Traumatic brain injury, multiple sclerosis, Huntington's disease, Parkinson's disease, progressive supranuclear palsy, intracerebral hemorrhage
Neurologic Acute caudate vascular lesions, alzheimer's disease, amphetamine withdrawal, anterior cingulate circuit damage, capsular genu, infarction, CNS lupus, damage to the basal ganglia, dementia, huntington's disease, hydrocephalus, intracerebral hemorrhage, multiple sclerosis, Parkinson's disease, progressive supranuclear palsy, Traumatic brain injury
Nutritional / Metabolic Huntington's disease
Oncologic No underlying causes
Opthalmologic Multiple sclerosis, hydrocephalus, intracerebral hemorrhage, traumatic brain injury, Parkinson's disease, progressive supranuclear palsy
Overdose / Toxicity No underlying causes
Psychiatric Depression, schizophrenia, Alzheimer's disease, dementia, Huntington's disease, Parkinson's disease, progressive supranuclear palsy, amphetamine withdrawal, hydrocephalus, traumatic brain injury
Pulmonary Multiple sclerosis, Huntington's disease, traumatic brain injury
Renal / Electrolyte No underlying causes
Rheum / Immune / Allergy Multiple sclerosis
Trauma No underlying causes
Urologic Hydrocephalus, multiple sclerosis, Parkinson's disease, progressive supranuclear palsy
Miscellaneous No underlying causes

Causes in Alphabetical Order

References



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