Search

Purpose: The aim of this study was to explore relations between speech sound disorder severity and selective mutism in a group of children with 7q11.23 duplication syndrome (Dup7), a genetic condition predisposing children to childhood apraxia of speech (CAS) and other speech sound disorders and to anxiety disorders, including selective mutism and social anxiety disorder. Method: Forty-nine children aged 4-17 years with genetically confirmed Dup7 completed the Goldman-Fristoe Test of Articulation-Second Edition (GFTA-2), the Expressive Vocabulary Test-Second Edition (EVT-2), and the Differential Ability Scales-Second Edition (DAS-II). Parents completed the Anxiety Disorders Interview Schedule-Parent (ADIS-P). Results: Mean standard scores (SSs) were 65.67 for the GFTA-2, 92.73 for the EVT-2, and 82.69 for the DAS-II General Conceptual Ability (GCA; similar to IQ). Standard deviations for all measures were larger than for the general population. GFTA-2 SS was significantly correlated with both EVT-2 SS and DAS-II GCA. Based on the ADIS-P, 22 participants (45%) were diagnosed with selective mutism and 29 (59%) were diagnosed with social anxiety disorder. No significant differences in performance on any of the measures were found either between the group with a selective mutism diagnosis and the group that did not have selective mutism or between the group with a selective mutism and/or social anxiety disorder diagnosis and the group that did not have either disorder. Conclusions: For children with Dup7, neither the diagnosis of selective mutism nor the diagnosis of selective mutism and/or social anxiety disorder was related to severity of speech sound disorder, expressive vocabulary ability, or overall intellectual ability. Accordingly, treatment for speech sound disorder alone is unlikely to lead to remission of selective mutism or social anxiety disorder. Instead, selective mutism and/or social anxiety disorder should be treated directly. Further research is needed to determine if these findings generalize to other populations, such as children with idiopathic CAS. [ABSTRACT FROM AUTHOR]

Cerebellar mutism syndrome (CMS) is a prevalent postoperative complication in children following posterior fossa tumor surgery, with a significantly variable incidence rate across different pathological types of tumors, being highest in medulloblastoma (24%-30%). The pathogenesis of CMS remains to be elucidated, but it is believed to be associated with damage to the cerebellocerebral circuits, harm to the fastigial nuclei of cerebellum and periaqueductal gray matter of the midbrain, and alterations in brain networks. Predictive models constructed based on the risk factors of CMS have not yet demonstrated the anticipated stability and have not been widely adopted in clinical settings. Pharmacological treatments are primarily based on clinical experience, yet their efficacy requires further validation, hence there is currently a lack of a clearly effective treatment method; non-pharmacological treatments, such as physical therapy, occupational therapy, and speech therapy, have shown some effect on improving the long - term quality of life. This review summarizes the pathogenesis and therapeutic advances of CMS, and future research should be dedicated to exploring the pathophysiological mechanisms of CMS, constructing more accurate predictive models, devising personalized treatment plans, and enhancing the long-term prognosis for children. [ABSTRACT FROM AUTHOR]

A 30-year-old woman had 5 days of visual hallucinations, nystagmus, memory impairment and mutism. On examination, she was disorientated with reduced attention span, gazeevoked nystagmus, paratonia and abnormal frontal reflexes. Cerebrospinal fluid (CSF) showed 80 cells, protein 0.41 g/L and glucose 3.2 mmol/L (plasma glucose 5.0 mmol/L). MR scan of the brain showed involvement of limbic and extra-limbic regions and brainstem. Commercial cell-based assays were negative, but tissue-based assays showed neuropil staining, and cell-based assays for anti-metabotropic glutamate receptor 5 (mGluR5) antibodies were positive in serum and CSF. Six months later, she was diagnosed with Hodgkin's lymphoma. This case emphasises the broader clinical spectrum of anti-mGluR5 encephalitis, challenging its initial characterisation as Ophelia syndrome. It underscores the significance of interpreting commercial cell- based assays and advocates for tissue-based assay testing followed by cell-based assay testing in serum and CSF for diagnosing rare autoimmune encephalitis. [ABSTRACT FROM AUTHOR]

Off-label metreleptin treatment resulted in cognitive, emotional and behavioral improvements of patients with anorexia nervosa, who presented with hypoleptinemia. We now report a case study of a 16-year-old female patient with atypical anorexia nervosa who was treated off-label with metreleptin for 11 days. She had lost 21 kg over 6 months. Her body mass index at referral for inpatient treatment was 20 kg/m2, her serum leptin level was just within the normal range (2.4 ng/ml). Dosing resulted in prominent improvements of mood and weight phobia entailing a comparatively brief inpatient treatment. The observed improvements are similar to those observed in patients with AN, suggesting overlapping mechanisms with respect to clinical effects induced by elevations of absolute or relative hypoleptinemia. Randomized controlled trials are warranted for both eating disorders. [ABSTRACT FROM AUTHOR]

Purpose: The Posterior Fossa Society, an international multidisciplinary group, hosted its first global meeting designed to share the current state of the evidence across the multidisciplinary elements of pediatric post-operative cerebellar mutism syndrome (pCMS). The agenda included keynote talks from world-leading speakers, compelling abstract presentations and engaging discussions led by members of the PFS special interest groups. Methods: This paper is a synopsis of the first global meeting, a 3-day program held in Liverpool, England, UK, in September 2022. Results: Topics included nosology, patient and family experience, cerebellar modulation of cognition, and cerebellar cognitive affective syndrome. In addition, updates from large-scale studies were shared as well as abstracts across neuroradiology, neurosurgery, diagnosis/scoring, ataxia, and rehabilitation. Conclusions: Based on data-driven evidence and discussions, each special interest group created research priorities to target before the second global meeting, in the spring of 2024. [ABSTRACT FROM AUTHOR]

Objective: To ascertain the presence of catatonia in cases of pediatric postoperative cerebellar mutism syndrome (PPCMS). Method: A systematic review of PPCMS case reports of patients aged 0–17 years with sufficient clinical information to extract catatonic phenomena was undertaken following PRISMA guidelines. Standardized catatonia rating scales were applied to selected cases retrospectively to ascertain whether diagnostic criteria for catatonia were met. A case known to the authors is also presented. Results: Two hundred twenty-one suitable full-text articles were identified. Following screening and application of inclusion criteria, 51 articles were selected plus seven more from their references, reporting on 119 subjects. All cases met Bush and Francis (BF) diagnostic criteria for catatonia, 92.5% Pediatric Catatonia Rating Scale (PCRS), 52.9% ICD-11, and 44.5% DSM-5. All patients presented with mutism. The next most frequent signs were immobility/stupor (77.3%), withdrawal (35.3%), mannerisms (23.5%), and excitement/agitation (18.5%). Most cases presented with stuporous catatonia (75.6%). Catatonia most frequently occurred following resection of medulloblastoma (64.7%). Preoperative hydrocephalus occurred in 89 patients (74.8%). Conclusion: Catatonia was frequent in this PPCMS sample, with a predominant stuporous variant; it should be considered in patients with PPCMS and assessed with reliable and validated instruments for prompt diagnosis and management. [ABSTRACT FROM AUTHOR]

Selective mutism (SM) is an anxiety disorder that is characterized by a child's persistent inability to communicate verbally in some or all contexts of social life. It is often associated with other cognitive–affective disorders. Performing cognitive–behavioral assessments and psychological interventions can be challenging due to the difficulty in administering standardized neuropsychological tests and involving family and teachers in the intervention program. In a single case study, a young Filipina girl with SM underwent a comprehensive neuropsychological assessment and received multimodal therapeutic intervention between the ages of 7 and 11. The psychological intervention included cognitive–behavioral psychotherapy to improve social–cognitive skills and learning abilities, reduce anxiety, and provide speech therapy. The parents and teachers were actively involved in the therapeutic process and a underwent a psycho-education program. Following this treatment, at the age of 11, the girl started verbalizing in therapy and school contexts, although she still used non-verbal strategies. There was also a gradual improvement in her communicative–linguistic skills and school learning. In conclusion, this report emphasizes the importance of applying an integrated and multimodal intervention to treat SM in children, including psychoeducation for parents and teachers. [ABSTRACT FROM AUTHOR]

Background: Psychosis is often solely described as a psychiatric presentation; however, it is vital that organic causes are eliminated, especially in children. Case presentation: We report the case of a 14-year-old girl who presented a 2-month history of self-neglect, poor school performance, and a week history of mutism. At initial presentation, her neurological examination was normal except for expressive aphasia, and occasional inappropriate laughing. First-line investigations showed low vitamin B12 and folate and normal magnetic resonance imaging. She was planned for follow up with psychiatrists. She presented about a week later with worsening symptoms. She had further investigations which revealed high homocysteine, in keeping with homocysteine remethylation disorder. She was started on betaine therapy after which she had a significant improvement in her symptoms. Conclusion: This case emphasizes the importance of thorough investigations of children with acute psychosis before making an assumption of a psychiatric cause, as reversible causes have better outcomes. [ABSTRACT FROM AUTHOR]

Posterior Fossa Syndrome (PFS) is a condition that can develop in children and adults following a cerebellar tumor resection surgery. The syndrome is characterized by multiple symptoms, including mutism, personality changes, and mobility problems. We present a case of a four-year-old boy diagnosed with posterior fossa tumor with secondary hydrocephalus who underwent an uneventful total resection of the tumor and developed posterior fossa syndrome, including mutism, was managed using lorazepam and made a full recovery of almost all of the symptoms he developed. Posterior fossa syndrome has multiple symptoms, most of which are usually transient. The exact pathophysiology and time to recovery are still not fully known. Patients with posterior fossa syndrome are managed with a multidisciplinary approach. Mutism resulting from this syndrome is proven to be successfully managed by lorazepam. [ABSTRACT FROM AUTHOR]

Introduction Sporadic Creutzfeldt-Jakob disease (sCJD) is a rapidly progressive neurodegenerative disease with public health implications. Mean age of onset is 68 years. Age-specific incidence declines after 80 years. This may arise from under-ascertainment or other biological features of the disease. Accurate characterisation of late-onset sCJD is important for early diagnosis, avoiding unnecessary investigations and improving ascertainment for public health purposes. Objective To phenotype the clinical features and investigation profile of sCJD in adults >80 years. Methods We analysed all probable and definite sCJD cases identified by the UK National CJD Research & Surveillance Unit over a 10-year period (2011–2021). Individuals were grouped by age of onset. Clinical features and investigation profiles were compared. Results 10.3% (123/1196) had an age of onset over 80. Median survival was shorter (3.2 vs 4.3 months; P  < 0.001). Pyramidal signs (48.3% vs 34.2%; P  = 0.008) and akinetic mutism (55.1% vs 33.2%; P  < 0.001) were more frequent. Psychiatric symptoms (26.3% vs 39.6%; P  = 0.01) and cerebellar signs (65.4% vs 78.6%, P  = 0.007) were less frequent. Cognitive impairment and myoclonus were highly prevalent regardless of age. Between age groups, the diagnostic sensitivity of cerebrospinal fluid real-time quaking-induced conversion (CSF RT-QuIC) (92.9% vs 91.9%, P  = 0.74) was comparable, electroencephalography was superior (41.5% vs 25.4%; P  = 0.006) and MRI was inferior (67.8% vs 91.4%; P  < 0.001). Conclusions Late-onset sCJD has distinct clinical features, shorter survival and a different profile of investigation sensitivity. CSF RT-QuIC, MRI brain and specialist CJD review is recommended in older adults with a rapidly progressive neurological disorder. Autopsy is valuable when the cause remains elusive. [ABSTRACT FROM AUTHOR]

In her examination of signing characters in works of Charles Dickens and Wilkie Collins, Jennifer Esmail highlights deaf characters' absence in Victorian fiction. Mutism is more common, for example, in the character of Mary Elizabeth Braddon's working-class, fingerspelling Detective Peters (70, 10n24). Even so, sign language – seen as 'primitive' and 'lacking [in] intellectual [...] rigor' – was rarely represented (Esmail 3). Dickens, Collins and Braddon, proto-detective novelists themselves, were preceded by Catherine Crowe, whose 1841 novel Susan Hopley features Julie le Moine, a female, cross-dressing sleuth whose mutism does not prevent her from testifying using 'signs' and 'the finger alphabet' (III.100, 125). Julie's undercover work not only crosses class, gender, and genre boundaries, but her non-verbal evidence challenges women's exclusion from '"masculine" systems of representation' symbolised by legal parlance (Irigaray 85). When detective fiction pits the private eye against traditional jurisprudential structures, the courtroom becomes a space where classed and gendered hierarchies inform testimonial evidence, reinforcing exclusionary principles that disenfranchise the 'Other'. The sign language, fingerspelling and lip-reading of Julie le Moine, Joseph Peters and Richard Marsh's Judith Lee expose ableist and sexist barriers that seek to expunge the detectives from the legal record by excluding them from public speech. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The siblings of children with mental disorders are more likely to experience mental health issues themselves, but there has been a lack of sibling studies on selective mutism (SM). The aim of this population-based study was to use national registers to examine associations between children with SM and diagnoses of various mental disorder in their siblings. All singleton children born in Finland from 1987 to 2009, and diagnosed with SM from 1998 to 2012, were identified from national health registers and matched with four controls by age and sex. Their biological siblings and parents were identified using national registries and the diagnostic information on the siblings of the subjects and controls was obtained. The final analyses comprised 658 children with SM and their 1661 siblings and 2092 controls with 4120 siblings. The analyses were conducted using generalized estimating equations. Mental disorders were more common among the siblings of the children with SM than among the siblings of the controls. The strongest associations were observed for childhood emotional disorders and autism spectrum disorders after the data were adjusted for covariates and comorbid diagnoses among SM subjects. The final model showed associations between SM and a wide range of disorders in siblings, with strongest associations with disorders that usually have their onset during childhood. Our finding showed that SM clustered with other mental disorders in siblings and this requires further research, especially the association between SM and autism spectrum disorders. Strong associations with childhood onset disorders may indicate shared etiologies. [ABSTRACT FROM AUTHOR]

Hearing loss is the most common sensory deficit and one of the most common congenital abnormalities. The estimated prevalence of moderate and severe hearing loss in a normal newborn is 0.1–0.3%, while the prevalence is 2–4% in newborns admitted to the newborn intensive care unit. Therefore, early detection and prompt treatment are of utmost importance in preventing the unwanted sequel of hearing loss on normal language development. The problem of congenital deafness is today addressed on the one hand with hearing screening at birth, on the other with the early (at around 3 months of age) application of hearing aids or, in case of lack of benefit, by the cochlear implant. Molecular genetics, antibody tests for some viruses, and diagnostic imaging have largely contributed to an effective etiological classification. A correct diagnosis and timely fitting of hearing aids or cochlear implants is useful for deaf children. The association between congenital deafness and "mutism", with all the consequences on/the consideration that deaf mutes have had since ancient times, not only from a social point of view but also from a legislative point of view, continued until the end of the nineteenth century, with the development on one side of new methods for the rehabilitation of language and on the other of sign language. But we need to get to the last decades of the last century to have, on the one hand, the diffusion of "universal newborn hearing screening", the discovery of the genetic causes of over half of congenital deafness, and on the other hand the cochlear implants that have allowed thousands of children born deaf the development of normal speech. Below, we will analyze the evolution of the problem between deafness and deaf-mutism over the centuries, with particular attention to the nineteenth century. [ABSTRACT FROM AUTHOR]

The article presents data on the impact of military events in Ukraine on the psychological state of children. It is noted that traumatic situations provoke the emergence of various psychological and anxiety disorders in children, including selective mutism. The article outlines the problematic issues of the state of research on the phenomenon of selective mutism and presents the results of the analysis of scientific publications on the essence and symptoms of selective mutism as well as tools for its diagnosing. In order to establish an accurate diagnosis, the author substantiates the need for a multi-level diagnosing and the use of various sources of information. The complex issues of diagnosing selective mutism are considered. It is emphasized that different social situations in children with selective mutism may not provoke the same patterns of non-speech behavior. It is emphasized that diagnosing procedure is also a social situation that can cause silence in a child with selective mutism. The significant role of parents and teachers as informants about a child's speech behavior is emphasized and the need for their involvement in the process of diagnosing a child is emphasized. The importance of conducting educational activities aimed at informing parents and teachers about the nature of this disorder, its diagnostic and treatment options is emphasized. It is noted that selective mutism has a significant impact on the emotional, cognitive and behavioral aspects of a child's life, negatively affects his/her academic performance, interferes with his/her socialization, and is often accompanied by comorbidities. The importance of early diagnosis of the disorder is emphasized. The diagnostic tools for selective mutism are outlined, and the importance of translating these tools into the native language of children, in particular Ukrainian, is noted. The article substantiates the necessity of using validated as well as scientifically and metrically verified tools for diagnosing selective mutism as a prerequisite for obtaining reliable diagnostic results, which is extremely important for further treatment. The importance of testing the psychometric properties of diagnostic tools on a Ukrainian sample of children is emphasized, and directions for future research are identified. [ABSTRACT FROM AUTHOR]

Some long-term outcomes for participants with selective mutism (SM) are elevated rates of phobic disorders, particularly social phobia, persistent communicative problems, and reduced self-esteem. However, data on the long-term outcomes of SM are scarce. In this study, by analyzing interpersonal anxiety, communication skills, and self-esteem among those who experienced SM and felt cured (SM-C-group: 30 females, 6 males, mean age 28.0, SD = 7.42, range 19–47 years), those who experienced SM and did not feel cured (SM-NC-group: 37 females, 4 males, mean age 27.4, SD = 7.24, age range 19–50 years), and those who had not experienced SM (Non-SM-group: 30 females, 30 males, mean age 26.4, SD = 7.62, age range: 20–48 years), we examined the long-term outcomes of SM and the factors that influence the feeling of being cured of SM. Results showed that the SM-C-group and SM-NC-groups had significantly higher interpersonal anxiety and significantly lower communication skills than the Non-SM-group. Moreover, the SM-C-group showed significantly lower interpersonal anxiety and significantly higher communication skills than the SM-NC-group. However, while there was no significant difference in self-esteem between the SM-C and SM-NCgroups, there was a significant difference between the SM-NC and Non-SM groups. The SM-C and SM-NC groups did not differ on the retrospective symptom load (SMQ-J), but did on the Current level of difficulty with speaking. The results of the logistic regression analysis predicted that communication skills and self-esteem did not influence the feeling of being cured of SM, but interpersonal anxiety and Current level of difficulty to speak did. Therefore, it is speculated that the intensity of this interpersonal anxiety and whether people with SM still felt difficulty in talking to others may have affected the feeling of being cured from SM. [ABSTRACT FROM AUTHOR]

Drawing attention to a key but overlooked moment in Montaigne's 'De la vanité', this article interrogates the relationship between two aspects of the essayist's 'franchise': his personal freedom and his frank, direct speech. It offers a reading that runs counter to Montaigne's self-characterization as 'le plus libre et moins endebté' person he knows, underscoring the precarity of his 'franchise' and his anxieties surrounding it. In this context, 'franchise' is shown to be hemmed in by a cluster of obligations, even as the essayist seeks to escape them. In contrast to the critical interest in Montaigne's reflections on free-thinkers and courageous speakers, including Socrates, Seneca and Cato the Younger, and complementing studies that have highlighted the motif of babble and loquacity in the Essais , this article focuses on Montaigne seeing himself in a frightful inversion of 'franchise': the looking glass of Lyncestes and the story of his death as a consequence of his disfluency. Reading 'franchise' in this light helps us to learn what Montaigne considered one of the first lessons worth learning: the difference between 'liberté' and 'licence'. [ABSTRACT FROM AUTHOR]

The present study addressed the different contributors to social anxiety in children with Selective Mutism (SM), with and without co-occurring Autism Spectrum Disorder (ASD) (SM + ASD). Seventy-five parents completed an online composite questionnaire consisting of the symptoms of SM and ASD, anxiety and sensory measures. The results found the SM + ASD group showed significantly higher levels of social anxiety and sensory avoidance compared to the SM only group. However, a simple mediation model revealed sensory avoidance to be a mediator of this relationship between the diagnosis and social anxiety.. Therefore, higher levels of sensory avoidance may help to differentiate social anxiety between the groups and may also be a sign of ASD in children with SM who have and/or are yet to receive an ASD diagnosis. [ABSTRACT FROM AUTHOR]

Aims Cerebral venous thrombosis is an uncommon neurological disease responsible for 0.5 to 1% of strokes that occur in the adult population. Diagnosis of cerebral vein thrombosis is challenging due to the wide variety of risk factors and clinical presentations. This paper aimed to present two cases of cerebral vein thrombosis with catatonia and akinetic mutism simulating catatonia. Patients & Methods In the present study, one patient with catatonia and another with akinetic mutism simulating catatonia were discussed based on the findings of magnetic resonance imaging. Findings Patients presented with dysfunction in speech, reduced motions, and other symptoms related to specific psychiatric disorders. In case 1, the findings of magnetic resonance imaging demonstrated hyperintensity in the left thalamus and thrombosis in the left jugular vein, sigmoid sinus, and transverse sinus. In case 2, there was thrombosis in her strait sinus. Anticoagulants were therefore prescribed, and complications improved except for short-term memory loss. Conclusion Catatonia and akinetic mutism are associated with various psychiatric and medical conditions that can be misdiagnosed if these disorders are not considered. [ABSTRACT FROM AUTHOR]

Selective mutism (SM) is an anxiety disorder (prevalence 1–2%), characterized by the consistent absence of speaking in specific situations (e.g., in school), while adequately speaking in other situations (e.g., at home). SM can have a debilitating impact on the psychosocial and academic functioning in childhood. The use of psychometrically sound and cross-culturally valid instruments is urgently needed. The aim of this paper is to identify and review the available assessment instruments for screening or diagnosing the core SM symptomatology. We conducted a systematic search in 6 databases. We identified 1469 studies from the last decade and investigated the measures having been used in a diagnostic assessment of SM. Studies were included if original data on the assessment or treatment of SM were reported. It was found that 38% of published studies on SM reporting original data did not report the use of any standardized or objective measure to investigate the core symptomatology. The results showed that many different questionnaires, interviews and observational instruments were used, many of these only once. The Selective Mutism Questionnaire (SMQ), Anxiety Disorders Interview Schedule (ADIS) and School Speech Questionnaire (SSQ) were used most often. Psychometric data on these instruments are emerging. Beyond these commonly used instruments, more recent developed instruments, such as the Frankfurt Scale of SM (FSSM) and the Teacher Telephone Interview for SM (TTI-SM), are described, as well as several interesting observational measures. The strengths and weaknesses of the instruments are discussed and recommendations are made for their use in clinical practice and research. [ABSTRACT FROM AUTHOR]

Mutism is the absence or marked paucity of verbal output due to functional or organic causes. Selective mutism is commonly seen in children with anxiety disorder. In psychiatric literature, long-standing mutism is most commonly associated with catatonic syndrome in adults. Although less commonly reported, long-standing mutism has also been associated with noncatatonic schizophrenia and posits a treatment challenge. Here, we describe two cases of long-standing noncatatonic mutism secondary to Schneiderian first rank symptoms, which were poorly responsive to conventional antipsychotic treatment and had good response to the combination of antipsychotics and electroconvulsive therapy (ECT). ECT is an underutilized treatment modality in patients with schizophrenia and is usually limited to catatonic states. The case series, thus, highlights the need for the development of an evidence base for the use of ECT in patients with noncatatonic mutism. [ABSTRACT FROM AUTHOR]

Introduction: Ifosfamide (IFX) is an alkylating drug used for chemotherapy to manage a wide range of malignancies including testicular, ovarian, head-and-neck cancers, lymphomas, and sarcomas. Central nervous system (CNS) toxicity is known to occur in 10%-40% of patients who are administered high doses of IFX. CNS toxicity includes an encephalopathy with underlying nonconvulsive status epilepticus manifesting with altered sensorium, mental confusion, seizures, ataxia, visual hallucinations, akinetic mute state extrapyramidal features, or coma. Case Report: We describe the case of a 65-year-old woman with a rapidly evolving confusional state and progressive decline in the fluency of speech progressing to mutism immediately after IFX chemotherapy. Results: Electroencephalogram (EEG) revealed evidence of nonconvulsive status epilepticus. The patient was managed with anticonvulsants, discontinuing IFX, and intravenous methylene blue infusion. Subsequently, the patient had significant improvement to an alert state with normalization of EEG abnormality. Conclusion: CNS toxicity following IFX usually manifests within 24 h of the drug administration, although clinical manifestations of toxicity may occur up to 4-6 days and a significant number of these patients may have a nonconvulsive status as the cause of the encephalopathy. Patients with encephalopathy following IFX should be evaluated with early EEG to assess for the presence or absence of a nonconvulsive status. Patients with a positive EEG would benefit from prompt and aggressive anticonvulsant therapy along with cessation of IFX therapy with or without intravenous methylene blue administration. [ABSTRACT FROM AUTHOR]

Virtual spaces that allow parents in the postpartum period to connect, support each other, and exchange information have been increasing in popularity. With the COVID-19 pandemic, many parents had to rely on virtual platforms as a primary means to connect with others and attend to their postpartum health. This study explored virtual postpartum support sessions through the web-based videoconferencing software, Zoom. Guided by feminist poststructuralism and sociomaterialism, we held seven virtual support sessions for parents caring for a baby 0–12 months in age, in Canada, and interviewed 19 participants about their experiences in the sessions. Our methodological approach allowed us to analyze discourses of (1) parenthood, (2) material realities of virtual environments, and (3) support and information on this virtual platform. The purpose of this research was to understand how technology influences postpartum support and learning through online videoconferencing for parents. Our findings document an overarching discourse of Zoom etiquette by which muting was a discursive practice that all participants used. The consistent use of the mute button while not talking structured conversation in virtual postpartum sessions and resulted in three themes: (1) minimizing disruptions; (2) taking turns; and (3) staying on task. The norm of using the mute button changed how parents received and gave support and information. Based on findings and broader literature, we discuss considerations for facilitation of virtual postpartum support sessions. [ABSTRACT FROM AUTHOR]

Introduction: Postoperative pediatric cerebellar mutism syndrome (POPCMS) is a significant complication observed after posterior fossa surgery for tumors, particularly in pediatric neurosurgery. This paper presents a literature review on the physiopathology, diagnosis, treatment, and long-term outcomes of POPCMS. Methods: A systematic review following PRISMA guidelines, searching for articles published in PubMed, Web of Science, and Lilacs in the last ten years. Inclusion criteria involved studies on human subjects under 18 years of age, focusing on the pathophysiology, diagnosis, treatment, and outcome of POPCMS. Results: The review identified 34 studies on POPCMS for final inclusion. Preoperative risk factors commonly associated with cerebellar mutism included midline tumor location, diagnosis of medulloblastoma, younger age at diagnosis, preoperative language impairment, brainstem infiltration, and tumor histology. The SHH subgroup was found to reduce the risk of CMS. Diagnostic criteria for POPCMS included language impairment, emotional lability, hypotonia, oropharyngeal dysfunction, dysphagia, cerebellar motor syndrome, cerebellar cognitive affective syndrome, and brainstem dysfunction. Treatment approaches varied, with medications showing potential benefits. Rehabilitation options for speech and language deficits were limited. Cognitive remediation programs showed promise in improving academic achievement and attention. A significant proportion of patients experienced clinical improvement. Conclusion: POPCMS remains a challenging complication following posterior fossa surgery. Further research is needed to develop standardized diagnostic criteria, effective treatments, and rehabilitation strategies to improve long-term outcomes for patients with POPCMS. [ABSTRACT FROM AUTHOR]

This study examined whether parental psychopathology (depression and social anxiety), parenting styles (authoritative, authoritarian, permissive) and practice (parental accommodation), and parental beliefs about children's anxiety are related to symptom severity in pediatric patients diagnosed with Selective Mutism (SM). Participants included 78 children, aged 3.5-8.5 years, with SM diagnosis, and their primary care-giving parent. The measures included clinical interviews, clinicians and parents' reports, and behavioral observations. Clinician reports of less severe SM symptoms in children were associated with more positive parental beliefs about their children's anxiety. Parents' reports of less severe symptoms in their children were associated with lower levels of parental social anxiety and accommodations, as well as with more authoritative and authoritarian parenting styles. Parental accommodations mediated the relationship between parental social anxiety and severity of children's symptoms, such that parents who are more socially anxious were also more accommodative, and this was related to greater SM severity. The findings of this study highlight important parenting characteristics involved in SM. These findings may lead to refining the psychological interventions for children with SM by allocating greater attention to parents' characteristics. Highlights: This study examined the relationships between parental characteristics and symptom severity in children with Selective mutism. Parents' social anxiety, authority style, accommodation and beliefs regarding their children's anxiety are related to children's symptom severity. Parental accommodation has a unique contribution to children's symptom severity and mediates its relationship with parents' social anxiety. [ABSTRACT FROM AUTHOR]

The article provides practical tips for pediatricians to assist children with selective mutism, emphasizing the importance of early recognition and intervention to mitigate long-term negative impacts on development and social skills. Topics include recognizing risk factors and comorbidities, distinguishing between selective mutism and shyness through structured interviews, and implementing multidimensional interventions such as cognitive-behavioral therapy and medication.

In our case report, a 29-year-old male patient with a known history of schizophrenia presented with altered mental status and catatonia and was found to have an enlarged (21mm) cavum septum pellucidum (CSP) on magnetic resonance imaging (MRI). He was subsequently treated with escitalopram, olanzapine, methylphenidate, lorazepam, and eight electroconvulsive therapy (ECT) treatments during his hospital course, after which his catatonia improved. We compared this to other cases in which a large CSP was identified and discussed the possibility of increased susceptibility to psychosis, specifically catatonia, which might be associated with this developmental anomaly. [ABSTRACT FROM AUTHOR]

Introduction: Postoperative pediatric cerebellar mutism syndrome (POPCMS) is a significant complication observed after posterior fossa surgery for tumors, particularly in pediatric neurosurgery. This paper presents a literature review on the physiopathology, diagnosis, treatment, and long-term outcomes of POPCMS. Methods: A systematic review following PRISMA guidelines, searching for articles published in PubMed, Web of Science, and Lilacs in the last ten years. Inclusion criteria involved studies on human subjects under 18 years of age, focusing on the pathophysiology, diagnosis, treatment, and outcome of POPCMS. Results: The review identified 34 studies on POPCMS for final inclusion. Preoperative risk factors commonly associated with cerebellar mutism included midline tumor location, diagnosis of medulloblastoma, younger age at diagnosis, preoperative language impairment, brainstem infiltration, and tumor histology. The SHH subgroup was found to reduce the risk of CMS. Diagnostic criteria for POPCMS included language impairment, emotional lability, hypotonia, oropharyngeal dysfunction, dysphagia, cerebellar motor syndrome, cerebellar cognitive affective syndrome, and brainstem dysfunction. Treatment approaches varied, with medications showing potential benefits. Rehabilitation options for speech and language deficits were limited. Cognitive remediation programs showed promise in improving academic achievement and attention. A significant proportion of patients experienced clinical improvement. Conclusion: POPCMS remains a challenging complication following posterior fossa surgery. Further research is needed to develop standardized diagnostic criteria, effective treatments, and rehabilitation strategies to improve long-term outcomes for patients with POPCMS.