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Radiology May 2024
Topics: Humans; Diffusion Tensor Imaging; Mutism; Male; Female; Cerebellar Diseases; Cerebellum; Child
PubMed: 38742972
DOI: 10.1148/radiol.240760 -
Ryoikibetsu Shokogun Shirizu 2003
Review
Topics: Child; Diagnostic and Statistical Manual of Mental Disorders; Humans; Mutism; Psychotherapy; Selective Serotonin Reuptake Inhibitors
PubMed: 14626062
DOI: No ID Found -
Child's Nervous System : ChNS :... Jun 2020Cerebellar mutism syndrome (CMS) is a serious source of morbidity following posterior fossa surgery in the pediatric population. However, methods for effectively...
PURPOSE
Cerebellar mutism syndrome (CMS) is a serious source of morbidity following posterior fossa surgery in the pediatric population. However, methods for effectively decreasing its incidence and impact remain unclear. It is our aim to examine the impact of adjusting surgical factors, namely the use of a telovelar approach and avoidance of cavitronic ultrasonic aspirator, on the incidence of CMS in our population as well as outlining potential pre-, intra-, and postoperative factors that may contribute to its development.
METHODS
Retrospective review was performed to identify patients undergoing posterior fossa surgery for resection of a medulloblastoma. Demographic, surgical, and postoperative data were collected. These data were analyzed for possible correlations to the risk of developing CMS via univariate analysis. For factors found to be significant, a multivariate analysis was performed to assess their independence.
RESULTS
Seven of 65 patients (10.8%) developed CMS postoperatively. Factors found to be significantly associated with a higher risk of CMS were the degree of retraction utilized during the procedure (p = 0.0000) and incision of the vermis (p = 0.0294). Although they did not reach the threshold of statistical significance, tumor vascularity (p = 0.19), adoption of a transvermian approach (p = 0.19), and lack of intraoperative imaging (p = 0.17) exhibited strongly suggestive trends towards a correlation with CMS.
DISCUSSION
In an effort to reduce the incidence and severity of CMS in our population, our institution adopted surgical practices that minimize tissue trauma and mitigate postoperative edema. This included the use of a telovelar over a transvermian approach to obviate the need for vermian incision, avoidance of the CUSA, and minimization of heavy retraction during surgery. This was successful in reducing the incidence of CMS from 39% in our medulloblastoma patients to 10.8%. The development of CMS after posterior fossa surgery appears to be a "two-hit" phenomenon requiring a combination of existing predisposition, surgical injury, and postoperative exacerbation. Therefore, it is critical to identify the factors involved at each stage and investigate treatments to target them appropriately.
Topics: Cerebellar Diseases; Cerebellar Neoplasms; Child; Humans; Medulloblastoma; Mutism; Postoperative Complications; Retrospective Studies
PubMed: 31273496
DOI: 10.1007/s00381-019-04240-x -
The International Journal of Social... Aug 2022
Topics: Anxiety Disorders; COVID-19; Humans; Mutism; Pandemics; Phobic Disorders
PubMed: 35652421
DOI: 10.1177/00207640221102728 -
The Israel Medical Association Journal... Dec 2002
Review
Topics: Anxiety; Fluoxetine; Humans; Monoamine Oxidase Inhibitors; Mutism; Phenelzine; Phobic Disorders; Prevalence; Selective Serotonin Reuptake Inhibitors
PubMed: 12516908
DOI: No ID Found -
Expert Review of Neurotherapeutics Feb 2009Children with selective mutism (SM) restrict speech in some social environments, often resulting in substantial academic and social impairment. Although SM is considered... (Review)
Review
Children with selective mutism (SM) restrict speech in some social environments, often resulting in substantial academic and social impairment. Although SM is considered rare, one or more children with SM can be found in most elementary schools. Assessment is performed to confirm the diagnosis, rule out psychological and medical factors that may account for the mutism, ascertain comorbid and exacerbating conditions needing treatment, and develop an intervention plan. Interventions are often multidisciplinary and focus on decreasing anxiety, increasing social speech and ameliorating SM-related impairment. Research is limited, but symptomatic improvement has been demonstrated with behavioral interventions and multimodal treatments that include school and family participation, as well as behavioral methods. Selective serotonin-reuptake inhibitors, especially fluoxetine, have also been found to be efficacious and merit consideration in severe cases. Persistence of some SM or anxiety symptoms despite treatment is common. Further development of treatments targeting specific etiological factors, comparative treatment studies and determination of optimal involvement of families and schools in treatment are needed to improve outcomes for children with SM.
Topics: Child; Humans; Mutism
PubMed: 19210197
DOI: 10.1586/14737175.9.2.235 -
Child Psychiatry and Human Development Apr 2020This study evaluates the current conceptualization of selective mutism (SM) as an anxiety disorder in the DSM-5 using a meta-analytic approach. In the absence of any... (Meta-Analysis)
Meta-Analysis
This study evaluates the current conceptualization of selective mutism (SM) as an anxiety disorder in the DSM-5 using a meta-analytic approach. In the absence of any systematic assessment of anxiety in the field of SM, we pooled prevalence data of comorbid anxiety disorders in a random-effects meta-analysis. On the basis of 22 eligible studies (N = 837), we found that 80% of the children with SM were diagnosed with an additional anxiety disorder, notably social phobia (69%). However, considerable heterogeneity was present, which remained unexplained by a priori specified moderators. The finding that SM is often diagnosed in combination with anxiety disorders, indicates that these disorders are not discrete, separable categories. Moreover, this finding does not help to elucidate the relation between SM and anxiety as an etiological mechanism or symptomatic feature. Broadening our research strategies regarding the assessment of anxiety is paramount to clarify the role of anxiety in SM, and allow for proper classification.
Topics: Anxiety; Anxiety Disorders; Child; Diagnostic and Statistical Manual of Mental Disorders; Humans; Mutism
PubMed: 31650460
DOI: 10.1007/s10578-019-00933-1 -
Journal of Behavior Therapy and... Sep 1988This paper introduces a procedural distinction between elective and progressive mutism. In elective mutism, a child elects to talk freely with intimates (e.g. family... (Review)
Review
This paper introduces a procedural distinction between elective and progressive mutism. In elective mutism, a child elects to talk freely with intimates (e.g. family members); in progressive mutism a child does not communicate verbally with anyone (including intimates). This analysis argues that clinicians' therapeutic goals and parents' expectations of treatment outcomes for elective mutism would differ from those applied to a case of progressive mutism and that the selection of the appropriate concept (elective vs progressive) to name the type of mutism prior to intervention would enhance treatment outcomes.
Topics: Behavior Therapy; Child; Humans; Mutism; Social Environment; Verbal Behavior
PubMed: 3069877
DOI: 10.1016/0005-7916(88)90042-0 -
Transcultural Psychiatry Feb 2024Although the diagnosis of selective mutism (SM) is more prevalent among immigrant children, the link between the disorder and an immigration background has been elusive....
Although the diagnosis of selective mutism (SM) is more prevalent among immigrant children, the link between the disorder and an immigration background has been elusive. Guided by ecocultural models of development, the current study aimed to construct a theory-based description of SM while considering individual, family, and contextual risk factors. Participants were 78 children with SM (38.4% with an immigration background), and 247 typically developed children (18.2% with an immigration background). Consistent with previous studies, our results suggest that anxiety was the most important predictor of SM symptoms, above and beyond immigration background. Immigration, especially if coupled with bilingual status and low family income, predicted increased levels of SM symptoms. Identifying multi-level predictors of SM may help researchers and clinicians to improve early identification and treatment of SM in culturally and linguistically diverse children.
Topics: Child; Humans; Mutism; Anxiety Disorders; Anxiety; Emigration and Immigration; Emigrants and Immigrants
PubMed: 37814531
DOI: 10.1177/13634615231202095 -
Child's Nervous System : ChNS :... Mar 2014Cerebellar mutism is a serious neurosurgical complication after posterior fossa surgery, but the cause, incidence and outcome remain incompletely defined. The aim of... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Cerebellar mutism is a serious neurosurgical complication after posterior fossa surgery, but the cause, incidence and outcome remain incompletely defined. The aim of this paper was to identify and review all reports of this phenomenon to better delineate and improve the evidence base.
METHODS
A systematic search and retrieval of databases was conducted using advanced search techniques. Review/outcomes criteria were developed, and study quality was determined.
RESULTS
The retrieval identified 2,281 papers of which 96 were relevant, identifying 650 children with cerebellar mutism. Causative factors, clinical features and outcomes were reported variably; papers focussed on multiple areas, the majority reporting incidence in single or series of case studies with little or no analysis further than description.
CONCLUSIONS
The complexity and variability of data reporting, likely contributing factors and outcomes make cerebellar mutism difficult to predict in incidence and the degree of impact that may ensue. A clear and accepted universal definition would help improve reporting, as would the application of agreed outcome measures. Clear and consistent reporting of surgical technique remains absent. Recommendations for practice are provided.
Topics: Adolescent; Cerebellar Diseases; Child; Child, Preschool; Cognition; Data Interpretation, Statistical; Female; Humans; Infant; Infant, Newborn; Male; Mutism; Neurosurgical Procedures; Publication Bias; Risk Factors; Treatment Outcome
PubMed: 24452481
DOI: 10.1007/s00381-014-2356-0