Transient Mutism and Pathologic Laughter in the Course of Cerebellitis

The phenomenon of cerebellar mutism with subsequent dysarthria is most commonly described as a part of posterior fossa syndrome after surgery for neoplasms in childhood. Pathologic laughter, on the other hand, is observed primarily in various neurologic diseases in adults. In the present case, a chi...

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Bibliographic Details
Published in:Pediatric neurology 2009-07, Vol.41 (1), p.49-52
Main Authors: Dimova, Petia S., PhD, Bojinova, Veneta S., PhD, Milanov, Ivan G., DSci
Format: Article
Language:English
Subjects:
Anti-Inflammatory Agents - therapeutic use
Ataxia - etiology
Atrophy - pathology
Biological and medical sciences
Cerebellum - pathology
Child
Encephalitis - complications
Encephalitis - drug therapy
Encephalitis - pathology
Encephalitis - psychology
Female
Humans
Laughter
Magnetic Resonance Imaging
Medical sciences
Mutism - etiology
Neurology
Pediatrics
Recovery of Function
Treatment Outcome
Vascular diseases and vascular malformations of the nervous system
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Summary:The phenomenon of cerebellar mutism with subsequent dysarthria is most commonly described as a part of posterior fossa syndrome after surgery for neoplasms in childhood. Pathologic laughter, on the other hand, is observed primarily in various neurologic diseases in adults. In the present case, a child manifested transient mutism and pathologic laughter during a severe cerebellitis. Headache, vertigo, and impaired consciousness developed during an acute respiratory infection. Thereafter, severe ataxia, mutism, and involuntary laughter became the main clinical features, as well as pyramidal signs. Magnetic resonance imaging revealed cerebellar swelling and T2 hyperintensity. During steroid treatment, a gradual vanishing of the pathologic laughter and improvement of the motor and speech functions occurred. Recovery was slow and incomplete, and follow-up magnetic resonance imaging showed cerebellar atrophy. This case confirms that mutism is a rare, but possible, manifestation in acute parainfectious cerebellitis and provides a novel example of pathologic laughter during this disease in childhood.
ISSN:0887-8994
1873-5150
DOI:10.1016/j.pediatrneurol.2009.01.013