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Dysarthria and dysphagia as long-term sequelae in a child treated for posterior fossa tumour
Petrea L Cornwell1, Bruce E Murdoch, Elizabeth C Ward
1Motor Speech Research Unit, Department of Speech Pathology and Audiology, University of Queensland, Brisbane, Queensland 4072, Australia. p.cornwell@uq.edu.au
Insights
This case report details persistent speech (dysarthria) and swallowing (dysphagia) issues in a child after posterior fossa tumor treatment. These long-term effects require careful management and pre-surgical counseling for pediatric cancer patients.
Area of Science:
- Pediatric Neurology
- Speech-Language Pathology
- Neuro-oncology
Background:
- Posterior fossa tumors (PFTs) are a significant concern in pediatric neuro-oncology.
- Treatment for PFTs can lead to persistent neurological deficits.
- Understanding long-term sequelae is crucial for comprehensive patient care.
Observation:
- A 7.5-year-old child, 2 years post-PFT treatment, exhibited persistent dysarthria and dysphagia.
- Speech assessment included respiration, phonation, resonance, articulation, and prosody.
- Videofluoroscopic evaluation of swallowing (VFS) assessed swallowing function.
Findings:
- Mild dysarthria with ataxic and lower motor neuron (LMN) components was diagnosed, without affecting overall speech intelligibility.
- Moderate dysphagia was observed, impacting all three phases of swallowing: oral preparatory, oral, and pharyngeal.
- The findings highlight the potential for lasting speech and swallowing impairments.
Implications:
- Persistent dysarthria and dysphagia following PFT treatment have significant implications for children's long-term health and quality of life.
- The need for tailored speech and swallowing rehabilitation programs is emphasized.
- Pre-surgical counseling should address the risks of developing dysarthria and dysphagia.
Abstract:
The current case report provides a comprehensive description of the persistent dysarthria and dysphagia evident in a 7.5 year old child treated for recurrent posterior fossa tumour (PFT). AC was assessed on a comprehensive perceptual and instrumental test battery incorporating all components of the speech production system (respiration, phonation, resonance, articulation and prosody) 2 years and 4 months following completion of her treatment. The nature of her swallowing impairment was investigated through the use of videofluoroscopic evaluation of swallowing (VFS). A mild dysarthria with ataxic and LMN components was identified, although overall speech intelligibility was not affected. A moderate dysphagia was also identified with impairment in all three phases of the swallowing process; oral preparatory, oral and pharyngeal. Dysarthria and dysphagia as persistent sequelae in children treated for PFT have implications for the long-term management of these children. The need for appropriate treatment regimes, as well as pre-surgical counselling regarding dysarthria and dysphagia as possible outcomes following surgery are highlighted.
