CEREBELLAR MUTISM - REPORT OF 7 CASES AND REVIEW OF THE LITERATURE

IT IS WELL known that degenerative disease, hemorrhage, infection, and neoplastic disease of the cerebellum can lead to speech disorders. Mu tism after posterior cranial fossa surgery was first reported by Rekat e et al. and Yonemasu in 1985. We review and analyze the cases of cere bellar mutism that are reported in the literature that is available in English. We found 39 reported cases that included details regarding m utism. We review and analyze a total of 46 cases, including those of o ur seven patients. The ages of the patients ranged from 2 to 61 years (mean, 10.4 yr). Ninety-one percent of the patients were children. The vermis was the site of the mass lesions in >90% of the cases. The pat hological findings of the lesions were as follows: 33 medulloblastomas , 7 astrocytomas, 4 ependymomas, 1 metastatic tumor, and 1 arterioveno us malformation. All mass lesions were considered to be large or very large. The latency for the development of mutism ranged from 0 to 6 da ys (mean, 1.7 d). The mutism lasted from 4 days to 4 months (mean, 6.8 wk). Dysarthric speech ensued after the mutism was resolved in 35 of 46 patients. Mutism was transient in all of the cases. Cerebellar muti sm is a transient complication of posterior fossa surgery for midline mass lesions.