paediatrics Brussels 17

Cerebellar Mutism Amy

• 9 yrs old presenting with double vision, headaches,, vomiting and neck stiffness • Bilateral papilloedema, upgaze limitation, left hand incoordinaiton, no ataxia, normal gait • CT scan midline cerebellar tumour, 4 cms, mild hydrocephalus. • Dexamethaosne 48 hours, operation to relieve hydrocephalus and remove tumour. Histo: Medulloblastoma • Post operatively 24 hours speech incomprehensible, left eye deviated down

• 48 hours Admitted to ICU with aspiration pneumonia • 72 hours developed triplegia of both arms and left leg, not responding to commands • At 3weeks: Swallowing and comprehension started to improve • At 7 weeks Underwent radiotherapy 35 / 54 Gy starting to swallow safely • At 4 months able to walk, talk in short sentences, had good comprehension and eat solid foods. • Plans were made for return to education thereafter