Loss or impairment of the ability to make decisions or act independently.
[New Latin, from Greek abouliā, indecision : a-, without; see a–1 + boulē, will.]
abulic a·bu'lic (-lĭk) adj.
abulia
Dictionary:
a·bu·li·a a·bou·li·a (ə-bū'lē-ə, -byū'-)  |
| 5min Related Video: Hyperboulia |
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Neurological Disorder:
Abulia |
Definition
Abulia is a state in which an individual seems to have lost will or motivation.
Description
Abulia is not a separate condition; rather, it is a symptom associated with various forms of brain injury. It may occur in association with a variety of conditions, including stroke, brain tumor, traumatic brain damage, bleeding into the brain, and exposure to toxic substances.
Causes and symptoms
Some research suggests that abulia occurs due to malfunction of the brain's dopamine-dependent circuitry. Injuries to the frontal lobe (the area of the brain responsible for higher thinking) and/or the basal ganglia (the area of the brain responsible for movement) can interfere with an individual's ability to initiate speech, movement, and social interaction. Abulia has been noted in patients who have suffered brain injuries due to stroke, bleeding into the brain from a ruptured aneurysm, trauma, brain tumor, neurological disease (such as Parkinson's disease), psychiatric condition (such as severe depression or schizophrenia), and exposure to toxic substances (such as cyclosporin-A).
An individual with abulia may not appear to have much will or motivation to pursue activities or initiate conversation. Such an individual may appear apathetic, disinterested, asocial, quiet or mute, physically slowed or still (hypokinetic), and emotionally remote.
Diagnosis
Abulia is not an individual diagnosis; it is a symptom that usually occurs as part of a constellation of symptoms accompanying a specific disorder. Diagnosis of the underlying disorder depends on the kinds of symptoms that co-exist with abulia. Psychiatric interview, magnetic resonance imaging (MRI), ultrasound, or computed tomography (CT) imaging of the brain, EEG, blood tests, and neurological testing may all be used to diagnose an underlying condition.
Treatment team
Treatment of abulia is usually part of a program of general rehabilitation for the symptoms accompanying the underlying condition. A neurologist or psychiatrist may lead a treatment team. Other professionals that may be involved include physical therapists, occupational therapists, recreational therapists, and speech and language therapists.
Treatment
There are no specific treatments for abulia. The underlying condition should be treated such as administering antidepressants or electroconvulsive therapy to depressed patients or antipsychotic medications to schizophrenic patients. Patients who have suffered brain injury due to stroke, bleeding, or trauma will benefit from rehabilitation programs that provide stimulation and attempt to re-teach skills.
Research has looked at the possibility of treating abulia with medications that boost the activity of dopamine throughout the brain, but this is far from becoming a standard treatment.
Prognosis
The prognosis of abulia depends on the prognosis of the underlying condition.
Resources
BOOKS
Friedman, Joseph H. "Mood, Emotion, and Thought." In Textbook of Clinical Neurology, edited by Christopher G. Goetz. Philadelphia: W. B. Saunders Company, 2003.
PERIODICALS
Al-Adawi, Samir. "Abulia: The Pathology of 'Will' and Dopaminergic Dysfunction in Brain-Injured Patients." Medical Sciences 1 (1999): 27–40.
Nishie, M. "Posterior Encephalopathy Subsequent to Cyclosporin A Presenting as Irreversible Abulia." Internal Medicine 42, no. 8 (1 August 2003): 750–755.
Pantoni, L. "Abulia and Cognitive Impairment in Two Patients with Capsular Genu Infarct." Acta Neurologica Scandinavia 104, no. 3 (1 September 2001): 185–190.
Vijayaraghavan. "Abulia: A Delphi Survey of British Neurologists and Psychiatrists." Movement Disorders 17, no. 5 (September 2002): 1052–1057.
Rosalyn Carson-Dewitt, MD
| Wikipedia: Aboulia |
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. It is also known as Blocq's disease (which also refers to abasia and astasia-abasia).[1] Abulia was originally considered to be a disorder of the will.[2] [3]
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. 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.
References
- ^ Robinson, Victor, Ph.C., M.D. (editor) (1939). "Bloq's disease, abulia, defined and described under the entry for abasia". The Modern Home Physician, A New Encyclopedia of Medical Knowledge. WM. H. Wise & Company (New York)., page 1.
- ^ Berrios G.E. and Gili M. (1995) Will and its disorders. A conceptual history. History of Psychiatry 6: 87-104
- ^ Berrios G.E. and Gili M. (1995) Abulia and impulsiveness revisited. Acta Psychiatrica Scandinavica 92: 161-167
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