Cerebellar Mutism

Definition

A transient speech disorder typically associated with resection of cerebellar tumors, particularly medulloblastomas involving the cerebellar vermis. Cerebellar mutism can also result from stroke in the cerebrovascular distribution, affecting the cerebellar peduncles and brainstem. Cerebellar mutism forms part of a syndrome of deficits, known as the posterior fossa syndrome (PFS).

Current Knowledge

Symptoms

As part of PFS, cerebellar mutism is associated with decreased or absent speech, irritability, hypotonia, ataxia, and the inability to coordinate voluntary movements, including the volitional motor aspects of speech. Mutism occurs within the first week of surgery (or cerebrovascular event) and its duration may be a matter of days or weeks. It is expected to resolve within 4 months. However, even with the return of functional speech, the quality of vocalizations may lack normalcy in being hypernasal, monotone, high pitched, slowed, and/or sparse.

Pathophysiology

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