The cerebellar contribution to language and sequential functions: evidence from a child with cerebellitis

We report the case of a 4 years and 2 months old girl, whose development was normal before she suffered from severe viral cerebellitis. When she recovered from the acute phase, a complete loss of speech was evident, although language comprehension was not impaired. Mutism disappeared after about two weeks, giving way to the aphonic utterance of a few words. After three months, her speech was slow and monotonous, without phonetic disturbances. She could only produce very simple and incomplete sentences in both spontaneous and constrained situations and she was able to maintain discourse sequentiality only under continuous guidance. No deficit in single-word recognition or naming was detected. Her sentence reproduction was good, while verbal fluency was very poor when no cue was given, but was normal with category cues. Her intelligence was within the normal range, but activities requiring programming, particularly those involving sequencing, were very defective. The patient's impairment is attributed to the failure of the cerebellar-frontal loops to activate strategies involved in processing and programming verbal and sequential functions.