Cause and outcome of cerebellar mutism: evidence from a systematic review.

Authors:
Rosa Reed-Berendt
Rosa Reed-Berendt
University of Leeds
United Kingdom
Bob Phillips
Bob Phillips
University of York
Susan Picton
Susan Picton
University of Leeds
United Kingdom
Paul Chumas
Paul Chumas
Leeds Teaching Hospitals NHS Trust
United Kingdom
Daniel Warren
Daniel Warren
Johns Hopkins University School of Medicine
United States
John H Livingston
John H Livingston
University of Manchester
United Kingdom
Ellen Hughes
Ellen Hughes
Leeds and York Partnership NHS Foundation Trust

Childs Nerv Syst 2014 Mar 23;30(3):375-85. Epub 2014 Jan 23.

Paediatric Neuropsychology, The Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, UK.

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.

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March 2014
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