Nonsurgical cerebellar mutism (anarthria) in two children

Pediatr Neurol. 2003 Jan;28(1):59-63. doi: 10.1016/s0887-8994(02)00503-9.


Cerebellar mutism (anarthria) is a well-described complication of posterior fossa tumor resection. It is accompanied by a characteristic behavior including irritability and autistic features. This syndrome is typically reversible within days to months. Underlying pathophysiology is unknown. We describe two children who presented with a similar clinical finding after nonsurgical cerebellar involvement, hemolytic-uremic syndrome in one and cerebellitis in the other. Postmortem pathologic findings in the first patient indicated cerebellar ischemic necrosis. Single-photon emission computed tomography in the second patient revealed diffuse cerebellar hypoperfusion with no supratentorial abnormalities, refuting a phenomenon of diaschisis between cerebellar and frontal connections. These findings confirm that this clinical syndrome may occur in a nonsurgical, nontraumatic context. They are consistent with recent integrative hypotheses explaining cerebellar anarthria.

Publication types

  • Case Reports

MeSH terms

  • Cerebellar Diseases / etiology
  • Cerebellar Diseases / pathology*
  • Cerebellum / pathology*
  • Child, Preschool
  • Encephalitis / complications
  • Female
  • Hemolytic-Uremic Syndrome / complications
  • Humans
  • Magnetic Resonance Imaging
  • Mutism / etiology
  • Mutism / pathology*