Transient mutism and pathologic laughter in the course of cerebellitis.
The phenomenon of cerebellar mutism with subsequent dysarthria is most commonly described as a part of posterior fossa syndrome after surgery for neoplasms in childhood. Pathologic laughter, on the other hand, is observed primarily in various neurologic diseases in adults. In the present case, a child manifested transient mutism and pathologic laughter during a severe cerebellitis. Headache, vertigo, and impaired consciousness developed during an acute respiratory infection. Thereafter, severe ataxia, mutism, and involuntary laughter became the main clinical features, as well as pyramidal signs. Magnetic resonance imaging revealed cerebellar swelling and T(2) hyperintensity. During steroid treatment, a gradual vanishing of the pathologic laughter and improvement of the motor and speech functions occurred. Recovery was slow and incomplete, and follow-up magnetic resonance imaging showed cerebellar atrophy. This case confirms that mutism is a rare, but possible, manifestation in acute parainfectious cerebellitis and provides a novel example of pathologic laughter during this disease in childhood.
Dimova
Petia S
PS
Clinic of Child Neurology, St. Naum University Hospital of Neurology and Psychiatry, Sofia, Bulgaria. pdimova@cablebg.net
Bojinova
Veneta S
VS
Milanov
Ivan G
IG
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001259:Ataxia / Q000209:etiology; D001284:Atrophy / Q000473:pathology; D002531:Cerebellum / Q000473:pathology; D002648:Child; D004660:Encephalitis / Q000150:complications* / Q000188:drug therapy / Q000473:pathology / Q000523:psychology; D005260:Female; D006801:Humans; D007845:Laughter; D008279:Magnetic Resonance Imaging; D009155:Mutism / Q000209:etiology*; D020127:Recovery of Function; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents