TY - JOUR

T1 - Consensus paper on post-operative pediatric cerebellar mutism syndrome

T2 - the Iceland Delphi results

AU - Gudrunardottir, Thora

AU - Morgan, Angela T

AU - Lux, Andrew L

AU - Walker, David A

AU - Walsh, Karin S

AU - Wells, Elizabeth M

AU - Wisoff, Jeffrey H

AU - Juhler, Marianne

AU - Schmahmann, Jeremy D

AU - Keating, Robert F

AU - Catsman-Berrevoets, Coriene

AU - Iceland Delphi Group

PY - 2016/7

Y1 - 2016/7

N2 - INTRODUCTION: Confusion has surrounded the description of post-operative mutism and associated morbidity in pediatric patients with cerebellar tumors for years. The heterogeneity of definitions and diagnostic features has hampered research progress within the field, and to date, no international guidelines exist on diagnosis, prevention, treatment, or follow-up of this debilitating condition. An international group of clinicians and researchers from multiple relevant disciplines recently formed a cohesive panel to formulate a new working definition and agree upon standardized methods for diagnosis and follow-up.METHODS: Consensus was obtained using the modified nominal group technique, involving four rounds of online Delphi questionnaires interspersed with a structured consensus conference with lectures, group work, and open discussion sessions.RESULTS: A new, proposed definition of "post-operative pediatric CMS" was formed, preliminary recommendations for diagnostic and follow-up procedures were created, two working groups on a new scoring scale and risk prediction and prevention were established, and areas were identified where further information is needed.DISCUSSION: The consensus process was motivated by desire to further research and improve quality of life for pediatric brain tumor patients. The Delphi rounds identified relevant topics and established basic agreement, while face-to-face engagement helped resolve matters of conflict and refine terminology. The new definition is intended to provide a more solid foundation for future clinical and research work. It is thought as a consensus for moving forward and hopefully paves the way to developing a standard approach to this challenging problem with the advent of better scoring methods and ultimate goal of reducing the risk of CMS.

AB - INTRODUCTION: Confusion has surrounded the description of post-operative mutism and associated morbidity in pediatric patients with cerebellar tumors for years. The heterogeneity of definitions and diagnostic features has hampered research progress within the field, and to date, no international guidelines exist on diagnosis, prevention, treatment, or follow-up of this debilitating condition. An international group of clinicians and researchers from multiple relevant disciplines recently formed a cohesive panel to formulate a new working definition and agree upon standardized methods for diagnosis and follow-up.METHODS: Consensus was obtained using the modified nominal group technique, involving four rounds of online Delphi questionnaires interspersed with a structured consensus conference with lectures, group work, and open discussion sessions.RESULTS: A new, proposed definition of "post-operative pediatric CMS" was formed, preliminary recommendations for diagnostic and follow-up procedures were created, two working groups on a new scoring scale and risk prediction and prevention were established, and areas were identified where further information is needed.DISCUSSION: The consensus process was motivated by desire to further research and improve quality of life for pediatric brain tumor patients. The Delphi rounds identified relevant topics and established basic agreement, while face-to-face engagement helped resolve matters of conflict and refine terminology. The new definition is intended to provide a more solid foundation for future clinical and research work. It is thought as a consensus for moving forward and hopefully paves the way to developing a standard approach to this challenging problem with the advent of better scoring methods and ultimate goal of reducing the risk of CMS.

KW - Cerebellar Diseases

KW - Consensus

KW - Databases, Factual

KW - Humans

KW - Iceland

KW - Mutism

KW - Pediatrics

KW - Postoperative Complications

KW - Risk Factors

KW - Surveys and Questionnaires

KW - Journal Article

KW - Review

U2 - 10.1007/s00381-016-3093-3

DO - 10.1007/s00381-016-3093-3

M3 - Review

C2 - 27142103

VL - 32

SP - 1195

EP - 1203

JO - Child's Nervous System

JF - Child's Nervous System

SN - 0256-7040

IS - 7

ER -