A 22-year-old active duty E1 Nepalese male who recently emigrated from Nepal suddenly exhibited strange behaviors and mutism during Advanced Individual Training. After receiving care from a hospital near his unit, he was transferred to Walter Reed Army Medical Center Inpatient Psychiatry for further evaluation and treatment. Although he was admitted with a diagnosis of psychosis not otherwise specified (NOS), after consideration of cultural factors and by ruling out concurrent thought disorder, a diagnosis of selective mutism was made. To our knowledge this is the first reported case of selective mutism in a soldier. This case serves as a reminder of the need for cultural awareness during psychological evaluation, diagnosis, and treatment of patients.
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http://dx.doi.org/10.7205/milmed.172.11.1213 | DOI Listing |
Cureus
December 2024
Department of Neurology, St. Joseph Medical Center, Stockton, USA.
Cerebellar mutism syndrome (also known as posterior fossa syndrome) has been mostly seen in pediatric patients after surgery for neoplastic disease and is characterized by mutism, with variable symptoms such as emotional lability, ataxia, apraxia, and hypotonia. While the mechanism is not precisely defined, it is thought to result from disconnections between the cortical and cerebellar brain networks. Presentation in adult patients is rare, with various etiologies including posterior fossa ischemia, hemorrhage, and tumors being most reported.
View Article and Find Full Text PDFClin Neurol Neurosurg
January 2025
Department of Neurological Surgery, Lenox Hill Hospital, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA.
Supplementary motor area (SMA) syndrome is characterized by contralateral akinesia and mutism, and frequently occurs following resection of tumors involving the superior frontal gyrus. The frontal aslant tract (FAT), involved in functional connectivity of the supplementary area and other related large-scale brain networks, is implicated in the pathogenesis of, and recovery from, SMA syndrome. However, intraoperative neuromonitoring of the FAT is inconsistent and poorly reproducible, leading to a high rate of postoperative SMA syndrome.
View Article and Find Full Text PDFNeurooncol Adv
December 2024
Research Department, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
Background: Postoperative pediatric cerebellar mutism syndrome (ppCMS) poses serious morbidity after posterior fossa tumor surgery. Neuroimaging studies aim to understand its pathophysiology, yet these vary in methodology and outcome measures. Therefore, we systematically reviewed the current literature to evaluate the evidence for differences in neuroimaging features between children with and without ppCMS.
View Article and Find Full Text PDFChildren (Basel)
November 2024
Department of Interdisciplinary Medicine, University of Bari and Aldo Moro, 70124 Bari, Italy.
Background: Posterior fossa syndrome (PFS), also known as cerebellar mutism syndrome, occurs in about 25% of pediatric patients undergoing resection of a posterior cranial fossa medulloblastoma. It is characterized primarily by mutism or reduced/impaired speech and may include variable symptoms such as motor dysfunction (apraxia, ataxia, hypotonia), supranuclear cranial nerve palsies, neurocognitive changes, and emotional lability. Long-term multidisciplinary rehabilitation is typically required, with recovery taking approximately six months, though many children experience long-term residual deficits.
View Article and Find Full Text PDFCerebellum
January 2025
Center for Language and Cognition, University of Groningen, PO box 716, 9700 AS, Groningen, the Netherlands.
Pediatric cerebellar tumor survivors may present with spontaneous language impairments following treatment, but the nature of these impairments is still largely unclear. A recent study by Svaldi et al. (Cerebellum.
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