| The pathophysiologic mechanism of cerebellar mutism. | |
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MedLine Citation:
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PMID: 16793430 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Cerebellar mutism (CM) is a postoperative complication of mainly pediatric posterior fossa surgery. Multiple theories exist for explaining this phenomenon. We have made an attempt to further understand this entity given a particularly interesting case as it relates to multiple pathophysiologic pathways. METHODS: We have reviewed the details surrounding a particularly interesting case of CM. A retrospective analysis of this patient's clinical history and recovery is described. An extensive literature review has been performed in conjunction with an attempt to help elucidate details and a better understanding of CM. RESULTS: A thorough analysis of existing theories as to the pathophysiologic mechanism of CM has been performed as it relates to the details of this particular case. A case is described in which a child exhibiting CM abruptly improved and made a relatively quick recovery after the triggering of the melodic speech pathway by way of watching and beginning to sing along with a video. It appears that this incident involving a familiar song catalyzed various speech pathways, which apparently were in some state of shock. This phenomenon seems to be a temporary entity involving not only the mechanical coordination of speech production, but also the initiation of speech itself. CONCLUSIONS: Evidence exists for a pathophysiologic pathway for speech by way of coordinating phonation and articulation. In addition, there seems to exist a pathway by which the initiation of speech may be altered or halted by posterior fossa pathology, namely, vermian or dentate nuclear injury. In particular to this case, we found that the incidental appreciation of other forms of speech, melodic in this instance, may be the key to help stimulate and accelerate the recovery from CM. |
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Authors:
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Burak M Ozgur; John Berberian; Henry E Aryan; Hal S Meltzer; Michael L Levy |
Publication Detail:
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Type: Case Reports; Journal Article; Review |
Journal Detail:
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Title: Surgical neurology Volume: 66 ISSN: 0090-3019 ISO Abbreviation: Surg Neurol Publication Date: 2006 Jul |
Date Detail:
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Created Date: 2006-06-23 Completed Date: 2006-08-18 Revised Date: 2007-08-21 |
Medline Journal Info:
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Nlm Unique ID: 0367070 Medline TA: Surg Neurol Country: United States |
Other Details:
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Languages: eng Pagination: 18-25 Citation Subset: IM |
Affiliation:
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Pediatric Neurosurgery, Children's Hospital of San Diego, San Diego, CA 92123, USA. bozgur@ucsd.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acoustic Stimulation
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methods Cerebellar Diseases / etiology, physiopathology*, rehabilitation Cerebellar Neoplasms / complications, physiopathology*, surgery Child, Preschool Humans Hydrocephalus / complications, physiopathology, surgery Male Medulloblastoma / complications, physiopathology*, surgery Music Therapy Mutism / etiology, physiopathology*, rehabilitation Neural Pathways / physiopathology Neurosurgical Procedures / adverse effects Recovery of Function |
| Comments/Corrections | |
Comment In:
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Surg Neurol. 2007 Jul;68(1):117; author reply 118
[PMID:
17586248
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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