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The Understanding of Pediatric Akinetic Mutism
Luiz Severo Bem1,2, Júlia Gemir3, Renata R M Cysneiros4
1Neurological Surgery, Hospital da Restauração, Recife, BRA.
Cureus
|February 5, 2021
Summary
Pediatric akinetic mutism syndrome, a complication of cerebellar injury in children, involves speech absence and emotional changes. Research highlights damage to specific cerebellar-cerebral pathways as the cause.
Area of Science:
- Neurology
- Pediatric Neuro-oncology
- Neuroscience
Background:
- Pediatric akinetic mutism syndrome is a recognized complication following posterior fossa tumor surgery in children.
- It is primarily associated with injuries to the cerebellar midline structures.
- The syndrome presents with mutism, emotional lability, and other neurological deficits.
Purpose of the Study:
- To review and elucidate the pathophysiological basis of pediatric akinetic mutism syndrome.
- To identify predictive factors contributing to the development of this syndrome.
- To synthesize recent research findings on cerebellar mutism.
Main Methods:
- Review of existing literature and prospective studies on cerebellar mutism syndrome.
- Analysis of neuroimaging techniques, including tractography and perfusion studies.
- Examination of cerebellar-cerebral circuits and pathways involved.
Main Results:
- Mutism is frequently linked to injuries affecting cerebellar tracts and cerebellar-cerebral circuits.
- Specific pathways implicated include the dentate-thalamus-cortical and dentato-rubro-thalamus-cortical.
- Advanced neuroimaging confirms alterations in these pathways in affected children.
Conclusions:
- Understanding the pathophysiological basis of pediatric akinetic mutism syndrome is crucial.
- Cerebellar-cerebral pathway dysfunction is central to the syndrome's development.
- Neuroimaging plays a key role in diagnosing and understanding the extent of injury.
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