Department of Neurology, University of Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany.
Brain Lang. 2013 Dec;127(3):327-33. doi: 10.1016/j.bandl.2013.01.001. Epub 2013 Feb 9.
Cerebellar mutism occurs in about 25% of children following posterior fossa tumor surgery. It is usually accompanied by other neurological and behavioral disturbances. Mutism is transient in nature lasting several days to months and is frequently followed by dysarthria. In addition, impairment of language and other neuropsychological functions can be found after long term follow up in the majority of patients. The pathophysiological background of mutism may be higher speech dysfunction mediated by crossed cerebello-cerebral diaschisis which is frequently found during the mute period. Foremost injury to the bilateral dentatothalamocortical tract appears to be critical for the development of cerebello-cerebral diaschisis and subsequent mutism. Direct cerebellar injury is the likely reason for persisting deficits after the mute period. Minimization of injury to the dentatothalamocortical tract during surgery may be promising in the prevention of mutism. While there is no established treatment of mutism, early speech and rehabilitation therapy is recommended.
小脑缄默症发生于约 25%接受后颅窝肿瘤手术的儿童。其通常伴有其他神经和行为障碍。缄默症为一过性，持续数天至数月，常伴有构音障碍。此外，在大多数患者的长期随访中可发现语言和其他神经心理学功能受损。缄默症的病理生理学基础可能是更高的言语功能障碍，这是由缄默期间经常发现的交叉小脑-大脑去抑制介导的。双侧齿状核-丘脑皮质束的首要损伤似乎对小脑-大脑去抑制的发展和随后的缄默症至关重要。缄默期后持续存在的缺陷可能是直接小脑损伤的原因。在手术过程中尽量减少对齿状核-丘脑皮质束的损伤可能是预防缄默症的一种有前途的方法。虽然目前没有缄默症的既定治疗方法，但建议早期进行言语和康复治疗。
