Transient mutism and speech disorders after posterior fossa surgery in children with brain tumours

Four patients aged 5 to 9 years with large tumours located in the posterior fossa (PNET, ependymoma or astrocytoma) are presented. Patients received standard neuropsychological assessments, including speech evaluation, prior to surgery. Following tumour resection these 4 children developed transient mutism or different types of speech and cognitive disorders, associated with behavioural disturbances.We describe course and results of repeated postoperative neurological and neuropsychological evaluations. Full recovery of speech was seen in 3 out of 4 patients; the only child with persistent symptoms was the one who already had neuropsychological deficits before surgery. However, despite fast recovery of the speech disorders more persistent behavioural problems were found in 3 out of 4 patients.Possible pathogenesis and anatomical location of this ''cerebellar speech syndrome'' are discussed, as well as the relevance of repeated neuropsychological assessments.