The authors experienced a case of mutism developed after the posterior fossa tumor surgery in a child. Mutism is a symptom mainly developed by supratentorial lesion in organic form. The possible pathogenesis of mutism after posterior fossa tumor surgery is discussed with a review of 18 additional previously reported cases.
Child* ; Humans ; Infratentorial Neoplasms* ; Mutism*

The authors report a case of rostral mesencephalic dysfunction due to obstructive hydrocephalus secondary to periaqueductal tumor who suffered multiple shunt failures and shunt revision. This patient presented with clinical syndromes, including akinetic mutism and diencephalic autonomic epilepsy. He had computed tomography(CT) and magnetic resonance(MR) findings of dilatation of ventricular system with periaqueductal tumor. The anatomical substrates of clinical findings are reviewed. A discussion of the probable mechanism proposes that dilatation of 3rd ventricle and rostral aqueduct sufficiently explains the entire syndrome.
Akinetic Mutism ; Dilatation ; Epilepsy ; Humans ; Hydrocephalus* ; Mesencephalon*

After immersion in a foreign language, speakers often have difficulty retrieving native-language words and may experience a decrease in its proficiency, this phenomenon, in the non-pathological form, is known as first language attrition. Self-perception of this low native-language proficiency and apprehension occurring when speaking is expected and, may sometimes lead these people to a state of social anxiety and, in extreme forms, can involve the withholding of speech as a primitive tool for self-protection, linking them to selective mutism. We report an unusual case of selective mutism arising from first language attrition in an Italian girl after attending a two-year "German language school", who successfully responded to a paroxetine-cognitive behavioral treatment (CBT) combination treatment.
Anxiety ; Cognitive Therapy ; Female ; Humans ; Immersion ; Mutism* ; Paroxetine ; Self Concept

The authors report one case of akinetic mutism with obstructive hydrocephalus. The patient suffered from multiple shunt failures and shunt revision. After multiple shunt revision, the patient fell into an akinetic-mute state. She appeared awake but was no response to painful somatosensory, loud auditory or threatening visual stimuli and she required total nursing care. This behavioral syndrome was no response to shunt revision but we were able to successfully treat a case of akinetic mutism after combination theraphy of Bromocryptine and Ephedrine.
Akinetic Mutism* ; Bromocriptine* ; Ephedrine* ; Humans ; Hydrocephalus ; Nursing Care

Akinetic mutism is a syndrome caused by various etiologies, and characterized by silent immobility and preserved alertness. The repetitive ventriculoperitoneal shunt for the recurrent hydrocephalus can be a forerunner of that. We present a man with akinetic mutism following two times of ventriculoperitoneal shunt revision. Akinetic mutism of the patient may be caused by the damage on the ascending dopaminergic projections. Symptoms were not alleviated by the normalization of ventricular size but by a large dose of bromocriptine.
Akinetic Mutism* ; Bromocriptine ; Cerebral Ventricles* ; Humans ; Hydrocephalus ; Ventriculoperitoneal Shunt

Neurological complications occur frequently in patients undergoing liver transplantation. We report a case of multi-ple neurologic complications including central pontine and extrapontine myelinolysis, seizure, and mutism after liver transplantation. Though the cause would be obscure and multifactorial, the hyponatremia with its rapid correction dur-ing operation and the side effects of the immunosuppressant would be the most probable causes in this case.
Humans ; Hyponatremia ; Liver Transplantation* ; Liver* ; Mutism ; Myelinolysis, Central Pontine ; Seizures

Cerebellar mutism (CM) is a rare neurological condition characterized by lack of speech due to cerebellar lesions. CM is often reported in children. We describe a rare case of CM after spontaneous cerebellar hemorrhage. The patient showed mutism, irritability, decreased spontaneous movements and oropharyngeal apraxia. Diffusion tensor imaging revealed significant volume reduction of medial frontal projection fibers from the corpus callosum. In Tracts Constrained by UnderLying Anatomy (TRACULA) analysis, forceps major and minor and bilateral cingulum-angular bundles were not visualized. Cerebello-frontal pathway reconstructed from the FMRIB Software Library showed continuity of fibers, with decreased number of fibers on qualitative analysis. These results suggest that cerebello-frontal disconnection may be a neuroanatomical mechanism of CM. Damage of brain network between occipital lobe, cingulate and cerebellum caused by hemorrhage may also have role in the mechanism of CM in our case.
Akinetic Mutism ; Apraxias ; Brain ; Cerebellum ; Child ; Corpus Callosum ; Diffusion Tensor Imaging ; Hemorrhage ; Humans ; Mutism* ; Occipital Lobe ; Stroke* ; Surgical Instruments

Locked-in Syndrome is a severe pontine stroke causing quadriplegia, lower cranial nerve paralysis, and mutism with preservation of only vertical gaze and upper eyelid movement in a conscious patient. We present a case of a Locked-in Syndrome patient who received communication training with augmentative and alternative communication equipment by using eye blinks. After 3 weeks of training, the patient was able to make an attempt to interact with other people, and associate a new word by Korean alphabet selection. Augmentative and alternative communication equipment which uses eye blinks might be considered to be beneficial in improving the communication skills of locked-in syndrome patients.
Communication Aids for Disabled ; Cranial Nerves ; Eye ; Eyelids ; Humans ; Mutism ; Paralysis ; Quadriplegia ; Stroke

We experinced 2 cases of reversible leukoencephalopathy, caused by 5-Fluorouracil derivatives(carmoful), presenting as akinetic mutism. Each patient was diagnosed as colon cancer and stomach cancer respectively and received operations. Their outcome was good without metastatic evidences, and carmoful was started orally 400mg in 1 case and 600mg in the other. Their clinical pictures were akinetic mutism, one and two months after the administration of carmoful. There were no metastatic lesions in the brain CT but bilaterally symmetric diffuse low densities of cerebral whites matter, predominantly in the frontal area, were noted. Carmoful was discontinued and replaced by conservative treatment. One and two months later, their clinical symptoms improved without specific treatment. Follow up brain CT was done in case 2, which revealed attenuation of the previous low densities.
Akinetic Mutism* ; Brain ; Colonic Neoplasms ; Fluorouracil* ; Follow-Up Studies ; Humans ; Leukoencephalopathies* ; Stomach Neoplasms

A 42-year-old man with left posterior inferior cerebellar artery (PICA) infarction presented with akinetic mutism and cognitive impairment. Initially he suffered from akinetic mutism and MRI-documented infarction in the distribution of the left PICA. Twelve days later he developed cognitive impairment. Neuropsychological tests were performed, with the results corrected for age and education being compared with published Korean norms. Impaired performances were evident on executive function testing, with difficulties in planning, abstract reasoning, set-shifting, and perseveration. Akinetic mutism and cognitive-affective syndrome may be a manifestation of unilateral PICA infarction.
Adult ; Akinetic Mutism* ; Arteries ; Education ; Executive Function ; Humans ; Infarction* ; Neuropsychological Tests ; Pica*