Lasting mutism associated with buccofacial apraxia

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Abstract
A right-handed 56-year-old male patient suddenly presented with mutism, and right hemiparesis. Hemiparesis quickly evolved and disappeared, and language slightly improved. However, 7 months later a total mutism and a very severe buccofacial apraxia associated with a mild aphasia were observed. A CT scan disclosed two almost homologous infarction areas: a left frontal opercular and a right orbitofrontal gyms infarction area. Several months later the patient passed away without any further change in his speech disorder. It is asserted that transient mutism can be associated with unilateral left damage, but lasting mutism associated with buccofacial apraxia requires bilateral lesions.
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