Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013362 (dysarthria)
 3,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The immunosuppressive agent FK-506 (tacrolimus) is one of the agents most commonly used to prevent rejection after liver transplantation. Neurologic toxicity related to FK-506 has been reported, including speech disorders; however, a detailed analysis of the speech disorder associated with use of FK-506 has not been presented. Herein we describe a patient who exhibited mutism, then severe apraxia of speech with a concomitant hypokinetic, spastic, and ataxic dysarthria after administration of FK-506. His residual mixed dysarthria, without radiographic evidence of a structural lesion, suggests dysfunction of one or more neurochemical systems. The pathophysiologic mechanisms underlying this intriguing entity remain obscure.
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PMID:Dysarthria and apraxia of speech associated with FK-506 (tacrolimus). 882 Jul 72

Mutism is a rare sequel of PCF tumor removal. Three patients aged 5 to 20 years old with mutism after posterior fossa surgery are presented. Suboccipital craniectomy was performed in all patients with grossly total removal of a medulloblastoma. The mutism that may occur after an operation for a PCF lesion has been explained in functional and/or organic terms. To date, 24 similar cases of mutism following cerebellar operations have been reported in the literature. We review the features of the syndrome in the light of the published cases and speculate on the underlying physiopathology. The absence of long tract or other brain stem signs, together with a presence of dysarthria during the recovery of speech, suggested a organic cerebellar cause of the mutism.
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PMID:Cerebellar mutism after posterior cranial fossa surgery. 891 62

The cerebellum can affect speech and language in a number of ways. The most obvious is dysarthria when motor movements are deprived of the regulatory control, which is one of the main functions of the cerebellum. Less well-known is cerebellar mutism, which most often occurs after the removal of a cerebellar tumour. It is unlikely that this is simply the result of dysarthria. The most controversial aspect of cerebellar function, and the main stress of this paper, is the contribution it may make to language production. A number of studies have suggested that the cerebellum can, indeed, be involved in both cognition and language. A number of these are reviewed, in particular, the results of diffuse and focal lesions of the cerebellum, and how these can affect the function of the cerebrum; and conversely how cerebral lesions can cause changes in the cerebellum. Positron emission tomography (PET) has been essential in the assessment of these patients. During human evolution parts of the cerebellum and their connections have enlarged enormously, and it would be surprising if these parts of the brain had not taken on new roles. To regard the cerebellum as only serving motor function is too narrow a concept.
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PMID:Speech, language, and the cerebellum. 905 70

An adult case of mutism and subsequent dysarthria after posterior fossa surgery is presented. An EEG performed during the mute phase showed widespread left hemisphere abnormality although the CT findings were normal. The possible mechanisms underlying this syndrome are discussed.
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PMID:Cerebellar mutism with subsequent dysarthria in an adult: case report. 915 7

Cerebellar mutism is a rare finding associated with resection of posterior fossa tumors or cerebellar hemorrhages. We reviewed the medical records of six children, aged 6 to 12 years, who developed cerebellar mutism after resection of a posterior fossa mass or as a result of posterior fossa trauma. From 1989 to 1994, 210 children underwent posterior fossa resection at our institution, and four developed mutism (an incidence of 1.6%). All four patients had primitive neuroectodermal tumors. The fifth patient experienced trauma, and another patient had an arteriovenous malformation (AVM). In four children, hydrocephalus developed as a result of their tumor or AVM. Four developed cerebellar mutism 24 to 48 hours after surgery or trauma, and one developed cerebellar mutism 5 days after surgery, coincident with hydrocephalus. In one, mutism occurred after a second resection was performed for a recurrence of his posterior fossa tumor. Cerebellar mutism lasted 10 days in one patient and 2 to 8 weeks in the other four. Dysarthria was apparent in four patients during the recovery phase. We suggest trauma to the dentate nucleus and/or its outflow tract, the superior cerebellar peduncle, as a cause of reversible mutism. Because posterior fossa tumors are common in children, mutism should be recognized as an important side effect of surgery.
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PMID:Cerebellar mutism in children: report of six cases and potential mechanisms. 916 12

A syndrome of mutism and subsequent dysarthria occurs frequently in children after resection of a cerebellar tumour. The role of orofacial and speech motor control in this syndrome has not been studied systematically. We examined simple and complex orofacial movements during the mute phase and shortly after the resumption of speech in five children with mutism and subsequent dysarthria. The recovery of complex orofacial movements coincided with the disappearance of the mutism.
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PMID:Complex orofacial movements and the disappearance of cerebellar mutism: report of five cases. 935 31

Two adults (aged 71 and 74 years) developed cerebellar mutism after posterior fossa surgery for a mass lesion in the superior cerebellar hemisphere or upper vermis. Histological examination showed one was a hemangioblastoma, the other a metastatic brain tumor. The tumors were totally removed via the occipital transtentorial approach. Both patients developed mutism on the 2nd postoperative day, which persisted for 3-4 weeks and was followed within 2-4 months by cerebellar dysarthria. Thereafter, their condition improved. Transient cerebellar mutism usually occurs in pediatric patients after the removal of a mass lesion in the upper vermis. Cerebellar mutism in adults is rare. The predominance of cerebellar mutism in children may be attributable to the predilection for vermian tumor and their tendency to experience personality and behavioral changes after posterior fossa surgery.
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PMID:Cerebellar mutism after posterior fossa surgery--two case reports. 946 94

The term "cerebellar mutism" refers to a specific disorder in which a complete but transient loss of speech, followed by dysarthria, occurs following resection of intrinsic posterior cranial fossa tumors or cerebellar hemorrhages, or upon trauma. Although it is well known that the lack of long-tract findings and cranial nerve (CN) involvement is the rule, the pathophysiology of cerebellar mutism has not been clearly elucidated. A review of the relevant literature disclosed 93 patients with this condition, the majority of these being in the pediatric age group. The neuropathological findings were as follows: 57 primitive neuroectodermal tumors (PNET), 19 astrocytomas, 10 ependymomas, 5 vascular malformations, 1 metastatic tumor, and 1 traumatic injury. The interval before the onset of mutism ranged from 0 to 168 h (mean 40.9 h). The mutism lasted from 1 to 168 days (mean 37.6 days). Subsequent dysarthria was present in 75 (80%) of the 93 patients. In this article, some specific recent illustrative reports are presented, and the concept of the role of the cerebellum in language and cognition is discussed. With these data as our point of departure, various hypotheses that have been advanced to explain the pathogenesis of this transient speech disorder are analyzed. The findings of the study suggest that the cause of the cerebellar mutism is the ischemia caused by vasospasm, as it usually developed after a latent period.
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PMID:Transient "cerebellar" mutism. 988 17

A 30-year-old female became comatose due to embolic occlusion of the basilar artery, caused by surgical injury to the origin of the vertebral artery during removal of a neurinoma in the upper thoracic paravertebral region. The basilar artery occlusion was treated by local fibrinolysis through a microcatheter. Two weeks later she recovered her consciousness but suffered mutism. Her speech disturbance was characterized by severe ataxic dysarthria known as "cerebellar mutism" but without cranial nerve paresis. The mutism gradually improved during the following 3 months. This is case of cerebellar mutism was apparently due to ischemic stroke. Disturbance by hypoperfusion of the cerebellum and brain stem may have been involved in the pathogenesis of cerebellar mutism.
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PMID:Cerebellar mutism after basilar artery occlusion--case report. 980 3

Cerebellar mutism after surgery for posterior fossa tumours in children is a well-described, though rare, entity. Most of these tumours are located in the region of the cerebellar vermis extending to the hemispheres. The authors report a case of cerebellar mutism in an 8-year-old boy who underwent surgical evacuation of a spontaneous vermian haematoma. We feel that his mutism was an extreme form of cerebellar dysarthria.
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PMID:Transient cerebellar mutism after evacuation of a spontaneous vermian haematoma. 980 55


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