Power and connectivity changes on electroencephalogram in postoperative cerebellar mutism

Area of Science:

• Pediatric Neurology
• Neuroscience
• Neurophysiology

Background:

• Cerebellar mutism syndrome (CMS) is a severe postsurgical complication after posterior fossa surgery in children, often leading to speech loss.
• The dentato-thalamo-cortical pathway is implicated, but physiological changes are understudied.
• Computed electroencephalogram (cEEG) offers a potential tool to explore CMS pathophysiology.

Observation:

• A nine-year-old girl with CMS post-ependymoma resection showed gradual recovery of language and motor function over 605 days.
• Serial cEEG monitoring revealed dynamic changes in brain activity.
• Specifically, delta band power fluctuated, while alpha band power increased, and connectivity in delta, beta, and gamma bands showed continuous improvement.

Findings:

• EEG power spectrum analysis demonstrated transient alterations in delta, theta, beta, and gamma bands.
• A continuous increase in occipital alpha band power was observed.
• Brain connectivity exhibited progressive enhancement across multiple frequency bands during recovery.

Implications:

• Long-term EEG analysis can reveal brain plasticity and functional remodeling in pediatric CMS.
• cEEG findings correlate with clinical recovery, suggesting its utility in understanding CMS.
• This case underscores the potential of EEG in elucidating the neurophysiological underpinnings of CMS.