Definition and Overview

• Posterior Fossa Syndrome (PFS): A constellation of neurological and behavioral symptoms occurring in children following posterior fossa tumor resection.
• Incidence: Occurs in approximately 8% of children undergoing posterior fossa tumor surgery.
• Etiology:
  • Damage to the cerebellum and cerebello-thalamo-cortical pathways.
  • Post-surgical edema, ischemia, or disruption of white matter tracts.
  • Affects structures like the dentate nuclei, superior cerebellar peduncles, and their projections.

  Key Clinical Features

  1. Cerebellar Dysfunction

     • Ataxia (truncal and appendicular).
     • Dysmetria.
     • Impaired balance and coordination.

  2. Oculomotor Dyspraxia

     • Difficulty initiating or coordinating eye movements.
     • Poor smooth pursuit or saccades.

  3. Oral Motor Dyspraxia

     • Impaired motor planning affecting speech and swallowing.
     • Contributes to mutism and dysarthria.

  4. Mutism

     • Commonly presents 1–2 days post-surgery.
     • Associated with the interruption of cerebello-thalamo-cortical pathways.
     • Often transient, with gradual recovery over weeks to months.

  5. Dysarthria

     • Acute Phase: Up to 30% of children exhibit dysarthria postoperatively.
     • Features: Distorted vowels, slow speech rate, voice tremor, and monopitch.
     • Comparison with Adult Ataxic Dysarthria: Pediatric cases show distinct features, such as persistent deficits in consonant production, pitch, and rate.

  6. Emotional Lability

     • Unpredictable mood swings and heightened emotional sensitivity.

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  Information

  Keywords: Posterior Fossa Syndrome

  Published:04 January 2025 Last Updated:04 January 2025