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Echopraxia also known as echomotism is the involuntary and non-goal-directed repetition or imitation of the observed movements of another. It is closely related to echolalia, the involuntary repetition of another's speech; both of which are subtypes of echo-reactions/echophenomena. The etymology of the term is from Ancient Greek: "ἠχώ (ēkhō) from ἠχή (ēkhē “sound”)" and "πρᾶξις (praksis, “action, activity, practice”)".

Overview
Echopraxia is most commonly associated with various disorders such as Tourette's Syndrome, autism, ganser syndrome, some forms of clinical depression, and schizophrenia (especially catatonic schizophrenia). Within these disorders, there are 2 types of echopraxia: automatic and voluntary. Automatic is usually associated with more progressed or chronic cases where the mimicking of actions is completely involuntary. Voluntary occurs with less extreme cases where the person's cognitive processes are more intact. It all depends on how much control the subject has of the mimicking. Sometimes a person only has an echoreaction when an action is directed strictly at them and not when a passerby makes a movement. Also, there are certain types of stimuli that are more likely to be mimicked, not just who is producing the stimuli. More complex or unfamiliar words or actions will be echoed while more simple stimuli generally is not repeated.

Causes
The exact causes of the disorders listed above are unknown, therefore the cause of echopraxia is hardly understood at all. However, there are several theories as to how echopraxia originates in the mind, some dealing with external sources and some with internal. According to R.A. Ford, Schneider (1938)  speculated that echopraxia is due to "a deterioration of the organization of cerebral dominance." Neurobiological evidence shows that echopraxia in schizophrenia begins deep in the brain's neurological processes, more specifically in an area known as the mirror neuron system (MNS). The firing of this special neuron as an action potential communicates with the inferior frontal gyrus (IFS). When it fires, a normally functioning brain would know to inhibit the observed action from reoccurring in the person. In an abnormally functioning brain, the resulting actions can be associated with decreased inhibitions and/or increased arousal; thus, the person will be unable to prevent themselves from mimicking the observed action. Echopraxia specifically in Tourette syndrome is considered to be a complex tic stemming from a "basal ganglia dysfunction and abnormal dopaminergic activity, as tics are suppressed by dopamine antagonists and are brought on, or exacerbated, by conditions characterized by dopaminergic overactivity." Luria (1973) concluded bilateral frontal lobe lesions to be the cause when he performed neuropsychological studies of patients specifically with this injury and found that their once normal behaviors were replaced with echopraxia. Their actions seemed even more bizarre when it was realized that the patients could no longer acknowledge the original intent of their own action once it was completed.

Fenichel (1946) had a psychodynamic perspective of the cause. He thought echopraxia is a "regression to an infantile level" where the patient is becoming less aware of reality and slipping into their own world. Reality is even less tangible when there are hallucinatory voices and delusions demanding the person to imitate an observers' behavior. These two features combined may cause someone to be completely unable to prevent themselves from imitating an observer. This break from the outside world to their own world can be triggered by an uncontrollable increase in id demands or an unbearable degree of guilt or moral anxiety produced by the superego.

The perceptual dysfunction theory, created by Stengel (1947) states that echopraxia develops because of the person "becoming overwhelmed with stimuli as a result of impaired selective attention" which agitates the balance of the body, self, and environment. With this inability to grasp what is reality and what is not, the affected person has a strong urge to act when observing another person yet has no inhibitory abilities to stop it. Stengel (1947) concluded that the common denominator for echopraxia in all disorders is "an urge to act or speak, a tendency to repetition, and an incomplete development or impairment."

Treatment
Treatment for echopraxia depends on which disorder it is a symptom of. For example, catatonic schizophrenic cases appear to respond well to Electroconvulsive therapy (ECT). ECT is used as a treatment for a variety of mental disorders and yet the exact neurological impact it has on the brain remains unclear. Drugs such as Chlorpromazine (Thorazine) are also used to alleviate symptoms. Since an immediate echoreaction can only occur in the presence of another person to mimic, either in person or on a television screen, simply closing their eyes or isolating themselves stops the mimicking. This provides some temporary relief of the aggravation that observers sometimes feel when being constantly mimicked.

Prevalence
There can not be an exact number of people suffering from echopraxia recorded for reasons such as limited psychological resources in developing countries and how situation-specific the act of imitating is. Emil Kraepelin, a German psychiatrist, figured that approximately up to 30% of people diagnosed with schizophrenia endure echopraxia. An American research experiment conducted by Shapiro et al. (1978) concluded that 35% of the subjects were affected by echolalia and 10% were affected by echopraxia of 145 cases. The mean age of both echophenomena is found to be in early adolescence.