title: Nonsurgical cerebellar mutism (anarthria) in two children.
abstract: 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.
authors.affiliation: Department of Neurology, Children's University Hospital Queen Fabiola, Université Libre de Bruxelles (ULB), Belgium.
authors.forename: Leena D
authors.initials: LD
authors.lastname: Mewasingh
authors.forename: Hazim
authors.initials: H
authors.lastname: Kadhim
authors.forename: Catherine
authors.initials: C
authors.lastname: Christophe
authors.forename: Florence J
authors.initials: FJ
authors.lastname: Christiaens
authors.forename: Bernard
authors.initials: B
authors.lastname: Dan
mesh_terms: 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*