title: Sudden benzodiazepine-induced resolution of post-operative pediatric cerebellar mutism syndrome: a clinical-SPECT study.
abstract: Post-operative pediatric cerebellar mutism syndrome (PPCMS) is a clinical syndrome arising from cerebellar injury and characterized by absence of speech and other possible symptoms and signs. Rare reports described some benefit after administration of dopamine agonist therapy, but no treatment has proven efficacy. In this paper, we report on the dramatic, sudden resolution of PPCMS induced by midazolam administration in a boy who underwent posterior fossa surgery for choroid plexus papilloma of the fourth ventricle. In addition to clinical improvement, post-midazolam single-photon emission computed tomography also demonstrated amelioration of brain perfusion.
authors.affiliation: Child Neurology Division, Department of Pediatrics and Child Neuropsychiatry, Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, 00161, Roma, Italy. nicita.f@gmail.com.
authors.forename: Francesco
authors.initials: F
authors.lastname: Nicita
authors.affiliation: Pediatric Oncology Division, Department of Pediatrics and Child Neuropsychiatry, Umberto I Hospital, Sapienza University of Rome, Rome, Italy.
authors.forename: Milena
authors.initials: M
authors.lastname: Paiano
authors.affiliation: Section of Nuclear Medicine, Department of Radiological, Oncological and Anatomo-Pathological Sciences, Umberto I Hospital, Sapienza University of Rome, Rome, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Liberatore
authors.affiliation: Child Neurology Division, Department of Pediatrics and Child Neuropsychiatry, Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, 00161, Roma, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Spalice
authors.affiliation: Pediatric Intensive Care Unit, Department of Pediatrics and Child Neuropsychiatry, Umberto I Hospital, Sapienza University of Rome, Rome, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Papoff
authors.affiliation: Section of Nuclear Medicine, Department of Radiological, Oncological and Anatomo-Pathological Sciences, Umberto I Hospital, Sapienza University of Rome, Rome, Italy.
authors.forename: Mariacristina
authors.initials: M
authors.lastname: Ullo
authors.affiliation: Department of Neurosurgery, Umberto I Hospital, Sapienza University of Rome, Rome, Italy.
authors.forename: Manolo
authors.initials: M
authors.lastname: Piccirilli
authors.affiliation: Pediatric Oncology Division, Department of Pediatrics and Child Neuropsychiatry, Umberto I Hospital, Sapienza University of Rome, Rome, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Clerico
authors.affiliation: Pediatric Oncology Division, Department of Pediatrics and Child Neuropsychiatry, Umberto I Hospital, Sapienza University of Rome, Rome, Italy.
authors.forename: Amalia
authors.initials: A
authors.lastname: Schiavetti
mesh_terms: D000293:Adolescent; D001569:Benzodiazepines / Q000494:pharmacology*; D002526:Cerebellar Diseases / Q000188:drug therapy* / Q000209:etiology; D002551:Cerebral Ventricle Neoplasms / Q000601:surgery*; D003388:Cranial Fossa, Posterior / Q000601:surgery; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000494:pharmacology*; D008297:Male; D008874:Midazolam / Q000008:administration & dosage / Q000494:pharmacology*; D009155:Mutism / Q000188:drug therapy* / Q000209:etiology*; D010212:Papilloma / Q000601:surgery*; D011183:Postoperative Complications / Q000188:drug therapy* / Q000209:etiology
chemical_list: D006993:Hypnotics and Sedatives; D001569:Benzodiazepines; D008874:Midazolam
keywords: Akinetic mutism; Cerebellar mutism; Dentate-thalamo-cerebral pathway; Dopamine; Posterior fossa surgery; Treatment