Published reports of acquired childhood dysarthria since 1980 were reviewed at University Hospital, Rotterdam; and the Department of Medical Psychology, Ziekenhuis Walcheren, Vlissingen, The Netherlands, and cases were classified on the basis of neuroradiological location of lesion and associated motor disorders. The majority of cases (20) were examples of mutism and subsequent dysarthria (MSD) following resection of cerebellar tumor. Slow articulation, monotony, and hoarse soft voice were the most frequent manifestation of dysarthria, and all patients had severe limb and trunk ataxia. Recovery or improvements in speech and motor disability were dissociated, dysarthria resolving first and almost completely while ataxia often persisted. Cerebellar MSD in children is different from the adult form of ataxic dysarthria, which is characterized by excess and equal stress resulting in scanning speech. Scanning speech was rarely observed in children. In 5 children with basal ganglia lesions and extrapyramidal movement disorders, dysarthria was characterized by hypophonia, stuttering, and difficulty in controlling rate of speech, similar to the hypokinetic dysarthria in adults. Acquired dysarthria in childhood requires a separate classification from that of adults, .
COMMENT. Acquired childhood dysarthria is classified as 1) ataxic type, usually following mutism as a complication of cerebellar tumor resection; and 2) hypokinetic type associated with basal ganglia lesions and extrapyramidal movement disorders.
The syndrome of cerebellar mutism and subsequent dysarthria is covered in Progress in Pediatric Neurology III. PNB Publishers, 1997;pp306-307. A report from University Hospital, Rotterdam cites 36 cases in the literature, including 5 of 15 children operated for cerebellar tumor, mainly medulloblastoma, at that hospital. The mutism was correlated with adherence of the tumor to the floor of the fourth ventricle. The dysarthria that followed lasted for 1 to 5 weeks.