Nonsurgical cerebellar mutism (anarthria) in two children.
Cerebellar mutism (anarthria) is a well-described complication of posterior fossa tumor resection. It is accompanied by a characteristic behavior including irritability and autistic features. This syndrome is typically reversible within days to months. Underlying pathophysiology is unknown. We describe two children who presented with a similar clinical finding after nonsurgical cerebellar involvement, hemolytic-uremic syndrome in one and cerebellitis in the other. Postmortem pathologic findings in the first patient indicated cerebellar ischemic necrosis. Single-photon emission computed tomography in the second patient revealed diffuse cerebellar hypoperfusion with no supratentorial abnormalities, refuting a phenomenon of diaschisis between cerebellar and frontal connections. These findings confirm that this clinical syndrome may occur in a nonsurgical, nontraumatic context. They are consistent with recent integrative hypotheses explaining cerebellar anarthria.
Mewasingh
Leena D
LD
Department of Neurology, Children's University Hospital Queen Fabiola, Université Libre de Bruxelles (ULB), Belgium.
Kadhim
Hazim
H
Christophe
Catherine
C
Christiaens
Florence J
FJ
Dan
Bernard
B
D002526:Cerebellar Diseases / Q000209:etiology / Q000473:pathology*; D002531:Cerebellum / Q000473:pathology*; D002675:Child, Preschool; D004660:Encephalitis / Q000150:complications; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000150:complications; D006801:Humans; D008279:Magnetic Resonance Imaging; D009155:Mutism / Q000209:etiology / Q000473:pathology*