Summary
Four patients aged 5 to 9 years with large tumours located in the posterior fossa (PNET, ependymoma or astrocytoma) are presented. Patients received standard neuropsychological assessments, including speech evaluation, prior to surgery. Following tumour resection, these 4 children developed transient mutism or different types of speech and cognitive disorders, associated with behavioural disturbances.
We describe course and results of repeated postoperative neurological and neuropsychological evaluations. Full recovery of speech was seen in 3 out of 4 patients; the only child with persistent symptoms was the one who already had neuropsychological deficits before surgery. However, despite fast recovery of the speech disorders more persistent behavioural problems were found in 3 out of 4 patients.
Possible pathogenesis and anatomical location of this “cerebellar speech syndrome” are discussed, as well as the relevance of repeated neuropsychological assessments.
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Akshoomoff NA, Courchesne E, Press GA, Iragui V (1992) Contribution of the cerebellum to neuropsychological functioning: evidence from a case of cerebellar degenerative disorder. Neuropsychologia 4: 315–328
Ammirati M, Mirzai S, Samii M (1989) Transient mutism following removal of a cerebellar tumour. Childs Nerv Syst 5: 12–14
Beichrodt N, Drenth PJD, Zaal JN, Resing WCM (1984) Revisie Amsterdamse Kinder Intelligentie test — Instructie, normen, psychometrische gegevens. Swets en Zeitlinger, Lisse
Black P, Jeffries JJ, Blumer D, Wellner A, Walker AE (1969) The post-traumatic syndrome in children. In: Walker AE, Caveness WF, Critchley M (eds) The late effects of head injury. Thomas, Springfield
van Bon WHJ (1982) Taaltests voor kinderen — Handleiding. Swets en Zeitlinger, Lisse
Brain WR (1965) Speech disorders, aphasia, apraxia and agnosia. Butterworths, London
Brus BT, Voeten MJM (1979) Een-minuut-test vorm A en B. Verantwoording en handleiding. Berkhout, Nijmegen
Catsman-Berrevoets CE, Van Dongen HR, Zwetsloot CP (1992) Transient loss of speech followed by dysarthria after removal of posterior fossa tumour. Dev Med Child Neurol 34: 1102–1117
Deelman BG, Liebrand WBG, Koning-Haanstra M, van den Burg W (1982) SAN test. Een afasietest voor auditief taalbegrip en mondeling taalgebruik. Kontruktie en normering. Swets en Zeitlinger, Lisse
Ferrante L, Mastronardi L, Acqui M, Fortuna A (1990) Mutism after posterior fossa surgery in children. J Neurosurg 72: 959–963
Haxby JV, Grady CL, Ungerleider LG, Horwitz B (1991) Mapping the functional neuroanatomy of the intact human brain with brain work imaging. Neuropsychologia 6: 539–555
Herb E, Thyen U (1992) Mutism after cerebellar medulloblastoma surgery. NeuroPediactrics 23: 144–146
Hudson LJ, Murdoch BE, Ozanne AE (198) Posterior fossa tumours in childhood: associated speech and language disorders post-surgery. Aphasiology 1: 13–18
Kamphuis GH (1962) Een bijdrage tot de geschiedenis van de Bourdoin test. Ned Tijdschr Psychol 17: 247–250
Kingma A, Kamps WA, Begeer JH (1989) Neuropsychologic and neurologic sequelae of brain tumour treatment in children: a prospective longitudinal study. Pediatr Neurosci 14: 162
Lezak MD (1983) Neuropsychological assessment. Oxford University Press, New York
Rekate HL, Grubb RL, Aram DM, Hahn JF, Ratcheson RA (1985) Muteness of cerebellar origin. Arch Neurol 42: 697–698
Salvati M, Missori P, Lunardi P, Ramundo OrlandoF (1991) Transient cerebellar mutism after posterior fossa surgery in an adult. Clin Neurol Neurosurg 4: 313–316
Halperin JM, Zeitchik E, Healy JM, Weinstein JM, Ludmans WL (1989) The development of linguistic and amnestic abilities in normal children. J Clin Exp Neuropsychol 11: 518–528
Spreen O, Strauss E (1991) A compendium of neuropsychological tests. Administration, norms and commentary. Oxford University Press, New York
Volcan J, Cole GP, Johnston K (1986) A case of muteness of cerebellar origin. Arch Neurol 43: 313–314
Wechsler D (1974) Manual Wechsler intelligence scale for children-revised. The Psychological Corporation, New York
Wechsler D (1963) Manual Wechsler preschool and primary scale of intelligence. The Psychological Corporation, New York
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Kingma, A., Mooij, J.J.A., Metzemaekers, J.D.M. et al. Transient mutism and speech disorders after posterior fossa surgery in children with brain tumours. Acta neurochir 131, 74–79 (1994). https://doi.org/10.1007/BF01401456
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DOI: https://doi.org/10.1007/BF01401456