Assuntos
Citalopram/efeitos adversos , Transplante de Coração , Transplante de Fígado , Atividade Motora/efeitos dos fármacos , Inibidores Seletivos de Recaptação de Serotonina/efeitos adversos , Discinesia Tardia/induzido quimicamente , Humanos , Masculino , Recuperação de Função Fisiológica , Fatores de Risco , Discinesia Tardia/diagnóstico , Discinesia Tardia/fisiopatologia , Resultado do Tratamento , Adulto JovemRESUMO
INTRODUCTION: Abulia is defined as a pathological state of amotivation, apathy, and global absence of willpower. It presents with a challenging array of overlapping symptoms, making effective identification and treatment difficult. CASE PRESENTATION: We describe the first known report of an adolescent with a ventricular assist device who developed abulia following a left middle cerebral artery (MCA) stroke who responded successfully to treatment with olanzapine. DISCUSSION: The neurobiological etiology of abulia is still unclear but is postulated to be related to deficits in the dopaminergic reward circuitry in the frontal-subcortical-mesolimbic regions. There have been reports of poststroke patients with abulia being treated by modulating this dopamine circuitry and in some cases with short-term low-dose olanzapine. CONCLUSION: Further research is needed to develop a better understanding of the pathophysiology of abulia leading to more effective treatment algorithms including more specific diagnostic tools and effective pharmacological interventions.