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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.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia

|October 18, 2011

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.

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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.