INS NYC 2024 Program

Poster	Poster Session 09 Program Schedule 02/16/2024 03:30 pm - 04:45 pm Room: Shubert Complex (Posters 1-60) Poster Session 09: Epilepsy \| Oncology \| MS \| Infectious Disease Final Abstract #53 Outcomes of a Posterior Fossa Syndrome Patient-Through a Neuroprotective Lens: A Case Study – A Case Study Sofia Iglesias Medina, Nicklaus Children's Hospital, Miami, United States Hala El Bahraoui, Nicklaus Children's Hospital, Miami, United States Kayleen Ball, Nicklaus Children's Hospital, Miami, United States Category: Medical/Neurological Disorders/Other (Child) Keyword 1: brain tumor Keyword 2: neuropsychological assessment Keyword 3: bilingualism/multilingualism Objective: Pediatric Brain Tumors (PBT) are the leading cause of solid tumor mortality in childhood. Posterior Fossa Tumors (PFT) have been associated with poor prognosis. Cognitive complications are present in 80% of patients in acute rehabilitation after surgical treatment. Most common deficits and late effects are noted in attention and executive functions (EF) due to the known connection between cerebellar, pre-frontal and frontal areas. Posterior Fossa Syndrome (PFS) or Post-Operative Cerebellar Mutism Syndrome (pCMS) is also commonly seen in about 25% of post-surgical PFT cases. It is described as a collection of neurological symptoms that include mutism/speech difficulties followed by motor speech difficulties, motor deficits and emotional/behavioral symptoms. In this case study, the neuropsychological profile of a 12-year-old bilingual boy with PFS/pCMS is presented and the importance of neuroprotective factors in this context is explored. Participants and Methods: Patient is a 12-year-old right-handed Mexican male. He is English/Spanish Bilingual and a simultaneous language learner from a high socioeconomic status (SES) and highly educated family. Patient presented with chronic emesis and headaches. After 6 months, he lost the ability to move his left-eye bilaterally. Imaging revealed a group 4 medulloblastoma and obstructive hydrocephalus. Patient underwent a sub-occipital gross total resection. He was treated per the ACNS 0331 protocol along with cranial-spinal high dose radiation and posterior fossa boost. Patient developed PFS/pCMS after resection. The patient’s mother initiated her own cognitive and physical rehabilitation activities at home during his acute phase. As part of outpatient neuro-oncology evaluation, the following tests were administered: EOWPVT-4^th, Spanish Bilingual Edition, WISC-V, ChAMP, D-KEFS, Trail Making Test A&B, Grooved Pegboard and various social-emotional questionnaires. Results: Patient displayed deficits in processing speed, delayed rote verbal memory, EF’s (cognitive flexibility, and mild working memory difficulties), bilateral fine-motor speed and dexterity and depression. Most striking in the patient’s neuropsychological profile was intact to above average functioning in other neurocognitive domains known to be sensitive to the effects of treatment and PFS/pCMS. Notably, above average expressive vocabulary (in both languages), fluid reasoning abilities and rote verbal recognition. As well as intact Full-Scale IQ, verbal comprehension abilities, rote verbal and visual immediate memory, and category fluency. Conclusions: Patient displayed deficits in processing speed, delayed rote verbal memory, EF’s (cognitive flexibility, and mild working memory difficulties), bilateral fine-motor speed and dexterity and depression. Most striking in the patient’s neuropsychological profile was intact to above average functioning in other neurocognitive domains known to be sensitive to the effects of treatment and PFS/pCMS. Notably, above average expressive vocabulary (in both languages), fluid reasoning abilities and rote verbal recognition. As well as intact Full-Scale IQ, verbal comprehension abilities, rote verbal and visual immediate memory, and category fluency.

Poster

02/16/2024
03:30 pm - 04:45 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease

Final Abstract #53

Outcomes of a Posterior Fossa Syndrome Patient-Through a Neuroprotective Lens: A Case Study – A Case Study

Sofia Iglesias Medina, Nicklaus Children's Hospital, Miami, United States
Hala El Bahraoui, Nicklaus Children's Hospital, Miami, United States
Kayleen Ball, Nicklaus Children's Hospital, Miami, United States

Category: Medical/Neurological Disorders/Other (Child)

Keyword 1: brain tumor
Keyword 2: neuropsychological assessment
Keyword 3: bilingualism/multilingualism

Objective:

Pediatric Brain Tumors (PBT) are the leading cause of solid tumor mortality in childhood. Posterior Fossa Tumors (PFT) have been associated with poor prognosis. Cognitive complications are present in 80% of patients in acute rehabilitation after surgical treatment. Most common deficits and late effects are noted in attention and executive functions (EF) due to the known connection between cerebellar, pre-frontal and frontal areas. Posterior Fossa Syndrome (PFS) or Post-Operative Cerebellar Mutism Syndrome (pCMS) is also commonly seen in about 25% of post-surgical PFT cases. It is described as a collection of neurological symptoms that include mutism/speech difficulties followed by motor speech difficulties, motor deficits and emotional/behavioral symptoms. In this case study, the neuropsychological profile of a 12-year-old bilingual boy with PFS/pCMS is presented and the importance of neuroprotective factors in this context is explored.

Participants and Methods:

Patient is a 12-year-old right-handed Mexican male. He is English/Spanish Bilingual and a simultaneous language learner from a high socioeconomic status (SES) and highly educated family. Patient presented with chronic emesis and headaches. After 6 months, he lost the ability to move his left-eye bilaterally. Imaging revealed a group 4 medulloblastoma and obstructive hydrocephalus. Patient underwent a sub-occipital gross total resection. He was treated per the ACNS 0331 protocol along with cranial-spinal high dose radiation and posterior fossa boost. Patient developed PFS/pCMS after resection. The patient’s mother initiated her own cognitive and physical rehabilitation activities at home during his acute phase. As part of outpatient neuro-oncology evaluation, the following tests were administered: EOWPVT-4^th, Spanish Bilingual Edition, WISC-V, ChAMP, D-KEFS, Trail Making Test A&B, Grooved Pegboard and various social-emotional questionnaires.

Results:

Patient displayed deficits in processing speed, delayed rote verbal memory, EF’s (cognitive flexibility, and mild working memory difficulties), bilateral fine-motor speed and dexterity and depression. Most striking in the patient’s neuropsychological profile was intact to above average functioning in other neurocognitive domains known to be sensitive to the effects of treatment and PFS/pCMS. Notably, above average expressive vocabulary (in both languages), fluid reasoning abilities and rote verbal recognition. As well as intact Full-Scale IQ, verbal comprehension abilities, rote verbal and visual immediate memory, and category fluency.

Conclusions: