Aboulia
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [3]
Overview
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
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
Causes
Common Causes
- Amphetamine withdrawal
- Dementia
- Intracerebral hemorrhage
- Traumatic brain injury
Causes by Organ System
Causes in Alphabetical Order
- Acute caudate vascular lesions
- Alzheimer’s disease
- Amphetamine withdrawal
- Anterior cingulate circuit damage
- Capsular genu infarction
- CNS lupus
- Damage to the basal ganglia
- Dementia
- Depression
- Huntington’s disease
- Hydrocephalus
- Intracerebral hemorrhage
- Multiple sclerosis
- Parkinson’s disease
- Progressive supranuclear palsy
- Schizophrenia
- Traumatic brain injury
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