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What is echopraxia? Causes, signs, treatment

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Mental health condition or symptom?SignsVs. echolaliaDiagnosisTreatmentSummary
Echopraxia is the involuntary copying of another person’s actions or movements. It is often a feature of catatonia and may also be present in epilepsy, major neurocognitive disorder, Tourette syndrome, or schizophrenia.
Medically reviewed by Nicole Washington, DO, MPH
Updated on

Also known as echomotism, echopraxia is an automatic bodily response. This means there is no intention behind mimicking another person.

Echopraxia may involve copying all types of behaviors, such as hand movements, walking patterns, or isolated actions like scratching the head. In all cases, the person repeating the behavior does not purposely do so.

Not everyone experiences echopraxia with the same intensity or frequency. In some mild cases, the symptom may not be as evident.

More research is needed to understand why echopraxia happens and determine the best ways to manage it.

Is echopraxia a mental health condition or a symptom?

Two hands mimicking each other as a symbol of echopraxia
Marc Bordons/Stocksy United

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR), echopraxia is not a stand-alone condition. Instead, it is a feature or symptom of a brain injury or mental health condition.

Some conditions that may involve echopraxia include:

  • catatonia
  • Tourette syndrome
  • schizophrenia
  • frontal lobe brain injury or disease

Rarely, echopraxia may happen in conditions like:

  • autism spectrum disorder
  • epilepsy
  • some autoimmune disorders

In the context of Tourette syndrome, echopraxia is considered a complex tic. Tourette syndrome is a neurodevelopmental disorder characterized by a variety of motor and vocal tics. Tics are sudden, persistent, and involuntary movements or vocal sounds.

Signs and characteristics of echopraxia

According to the DSM-5-TR, echopraxia happens when a person persistently copies other people’s movements. It may occur in direct interaction with others or by watching them in a video or TV show.

Some examples of echopraxia may include mimicking:

  • facial expressions
  • walking patterns
  • crossing of legs or arms
  • scratching or touching a body part
  • fidgeting

Echopraxia may also involve imitating behaviors potentially harmful to yourself or others — for example, kicking, pulling hair, and punching.

Because echopraxia tends to be persistent, it may cause social challenges. Other people may not understand why you mirror some or all of their movements.

Differences between echopraxia and echolalia

Echopraxia often occurs with other mimicking responses, including echolalia. Echolalia is the involuntary repetition of other people’s words, sounds, or phrases.

Echolalia is common in people with:

  • autism spectrum disorder
  • schizophrenia
  • major neurocognitive disorder (formerly known as dementia)
  • Tourette syndrome

Examples of echolalia may include involuntarily repeating or vocalizing:

  • a word someone else just said as part of a sentence
  • commands or sentences heard repeatedly from others (like “It’s time to eat!” at mealtime)
  • a part of a song

How is echopraxia diagnosed?

No tests exist to diagnose echopraxia. Healthcare professionals may need to observe your behavior in a clinical setting or refer to accounts that you and those close to you provide.

A healthcare professional may also want to explore what other symptoms you have to determine the root cause of echopraxia. Some symptoms they may look for may be:

  • unresponsiveness or stupor, muscular rigidity, mutism, and agitation in catatonia
  • hallucinations, disorganized speech, lack of motivation, and delusions in schizophrenia
  • eye movements, shrugging, facial grimacing, twisting, or grunting in Tourette syndrome

How is echopraxia treated?

Managing echopraxia may depend on the root cause and the severity of your symptoms. Research is limited on echopraxia-specific treatment, and management strategies depend on the underlying cause.

Only a healthcare professional may diagnose echopraxia accurately and work with you to determine a treatment plan that responds to your needs. For example, schizophrenia treatment may reduce the likelihood of echopraxia.

Some medications prescribed for certain conditions associated with echopraxia may also improve the symptom. Depending on the underlying cause of echopraxia, these may include:

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Echopraxia refers to the involuntary and meaningless mimicking of other people’s movements. It is a frequent feature of conditions like catatonia, Tourette syndrome, and schizophrenia.

Echopraxia often occurs along with other mimicking (or “echo”) symptoms, like echolalia. This is the involuntary copying of words and sounds.

No treatment is available for echopraxia alone. Management often involves the treatment of the underlying cause.

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