ALTHOUGH patients with similar clinical syndromes had been described earlier,1-3the term "akinetic mutism" came into use following a report in 1941 by Cairns et al4of a 14-year-old girl with an epidermoid cyst of the third ventricle. During the eight years of her illness she had several periods of "akinetic or trance-like mutism" in which she was essentially inert with her eyes open and did not speak. As time went on the term became firmly entrenched in the clinical literature and numerous cases have been reported. Klee5reviewed the literature in 1961, and although he did not give specific figures, he made reference to over 27 cases which could be classified as akinetic mutism. The syndrome has been reported with lesions in the region of the third ventricle1,4,6-8thalamus, and basal ganglia,9-13mid-brain,12,14-16anterior cingulate gyrus,17-19and also associated with basilar