Abstract
Objective Postoperative paediatric cerebellar mutism syndrome (pCMS) can occur in children after resection of a posterior fossa brain tumour. It is characterised by mutism or reduced speech and emotional lability, often with disturbances in motor and cognitive functions. This study aimed to analyse the clinical features and risk factors for pCMS in the Ghent University Hospital.
Methods Retrospective data of children treated for posterior fossa tumours in the Ghent University Hospital between 2008 and 2022 were reviewed, using the 2016 Delphi consensus definition of pCMS.
Results Twenty-two out of 69 patients (32%) developed pCMS. Motor deficits were most frequent. Dysarthria was the leading speech impairment, mutism was the primary language disorder. The most prevalent affective disorder was anxiety. Univariate analysis showed significant associations with medulloblastoma (OR 3.41; 95%CI 1.19-9.78), brain stem invasion (OR 4.76; 95%CI 1.24-18.31) and midline tumour location (OR 1.58; 95%CI 1.30-1.91). Conversely, pCMS was less frequent in pilocytic astrocytomas (OR 0.21; 95%CI 0.06-0.73) and in tumours larger than 5 cm (OR 0.08; 95%CI 0.02-0.39).
Conclusion This study highlights the clinical features and risk factors of pCMS in children treated for posterior fossa tumours. While motor deficits were most commonly reported, disorders in speech, language, and affective and cognitive function may have been underrecognised. Risk factors such as tumour type, brain stem invasion and midline location, are consistent with existing literature, whereas a “protective” effect of larger tumours might be attributed to the predominance of large pilocytic astrocytomas in this cohort.