A child with mutism after bilateral thalamic infarction.
C Pluchon1, N Jaafari, M-N Loiseau-Corvez
1Service de Neurologie, Unité de Neuropsychologie et Rééducation du Langage, Centre Hospitalier Universitaire (CHU) de Poitiers, Université de Poitiers, 2 rue de la Milétrie, 86021, Poitiers, France.
Summary
Sudden mutism in a child, rarely seen in adults, occurred after bithalamic infarction. This case suggests speech-specific akinetic mutism may result from such pediatric thalamic lesions.
Area of Science:
- Neurology
- Pediatric Neurology
- Neuroimaging
Background:
- Mutism following thalamic lesions is uncommon in pediatric cases.
- Thalamic lesions can lead to diverse neurological deficits, including speech and motor impairments.
Observation:
- A 6.5-year-old girl presented with acute mutism and reduced alertness.
- Brain MRI revealed bilateral thalamic hyperintensities (T2-FLAIR), indicative of bithalamic infarction in the paramedian thalamic artery territories.
Findings:
- The patient experienced mutism followed by speech initiation deficits, characterized by slow and slurred speech.
- Neurological recovery was observed, with speech returning to normal within 3 months.
Implications:
- This case highlights that mutism can manifest as a focal neurological deficit, specifically akinetic mutism limited to speech production in children.
- Pediatric bithalamic infarction should be considered in the differential diagnosis of sudden-onset mutism in children.
- Further research is warranted to understand the specific mechanisms and long-term outcomes of speech-related akinetic mutism in pediatric thalamic lesions.
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