Some diseases represent a conundrum to our understanding of underlying pathologies and even normal physiology. Autistic Spectrum Disorder stands at that point within its molecular and genetic characteristics, developmental divergence, neurodegenerative processes, relationship between environmental events, immunological mechanisms and possible viral etiologies. It still remains to be an interesting entity, impairing the function of the brain and mind in many ways. This is the problem: Autistic Spectrum Disorder is so obscure that it can’t be recognized before age of 5 generally. It is doubtless true that late diagnosis brings about the downfall of the therapy. In as much as we are not able to understand autism through our knowledge of today, it will be a better way to try to understand the brain by deciphering the mechanisms of Autism.

Therefore, we would like to talk about some common points between Autistic Spectrum Disorder and Cerebellar Mutism. We observe Cerebellar Mutism after resection of midline posterior fossa tumors typically. It also rarely develops shortly after traumatic, vascular or infectious events of the cerebellum. There is a delayed onset of mutism following a brief interval of 1-2 days of relatively normal speech post surgery. Transient mutism lasts from 1 day to six months followed by severe dysarthria, that may either recover completely in 1-3 months or speech deficits may persist even up to 10 years of post surgery. And more, it presents other neurological manifestations such as long tract signs and neurobehavioural abnormalities frequently

There are some interesting parallels that show some aspects of dysfunction both in Autistic Spectrum Disorder and Cerebellar Mutism that we couldn’t keep from discussing the paradigms. The paradigms that we built on diseases to understand the functions of the brain by narrowing. We will numerate these similarities to reduce the anarchy of our subject:

1. Cerebellar damage produces disturbances of smooth ocular pursuit- disturbances of smooth ocular pursuit occur in autistic spectrum disorder and CM.

2. Cerebellar lesions can produce mutism and dysarthria, symptoms sometimes seen in autistic spectrum disorder and CM.

3. The cerebellum projects to systems involved in motor initiation, a function that is abnormal in both autistic spectrum disorder and CM.

4. The cerebellum projects to all levels of the reticular activating system, a system that has been suggested to be dysfunctional in both autistic spectrum disorder and CM.

5. The cerebellum modulates forebrain serotonergic, dopaminergic, and noradrenergic levels-levels of these neurotransmitters have been suggested to be abnormal in autistic spectrum disorder and CM.

6. The cerebellum modulates hippocampal activity and projects via the hypothalamus to the amygdale-both of these limbic regions have been hypothesized to be dysfunctional in autistic spectrum disorder and CM.

7. The cerebellum has monosynaptic connections with hypothalamic nuclei-neuroendocrine data and measures of physical growth suggest hypothalamic dysfunction in autistic spectrum disorder and CM.

8. The cerebellum and two regions within the frontal lobes are active in certain language tasks-language is abnormal in autistic spectrum disorder and CM. This has been shown in SPECT studies to be cerebellar diaschisis.

9. Cerebellar lesions in mammals disturb motivated behavior and reduce social interactions, functions that are disturbed in autistic spectrum disorder and CM.

10. Pressure therapy has a calming effect for autistic individuals. A squeezing machine invented by an autistic is completely lined with foam rubber, and the user has complete control over the duration and amount of pressure applied. Squeezing is an effective treatment modality for autistic spectrum disorder. In CM, speech recovery starts from a couple of days to several months postoperatively. Close contact with and/or gently squeezing of patients by hugging with their parents during the postoperative period may act as a squeezing machine and accelerate the recovery.

11. An autistic patient stated that throughout elementary school her speech was still abnormal. Often, it took her longer than other children to start getting her words out. However, she found it easy to sing. Moreover, in a unique case study of CM, described a 5-yearold boy with medulloblastoma and associated hydrocephalus [1]. On his first day postoperatively, he exhibited cerebellar dysmetria, dysdiadokinesia, and CM. Although motor symptoms continued to improve over the next few weeks, the CM remained. Serendipitously, the patient was exposed to music that they were familiar with or which was their favorite, and they began singing without prompts, but remained mute without the music.

It’s clear that the cerebellum is involved in a wide range of tasks, including non-motor functions, such as language, thought modulation, emotions, and the ability to organize symbolic activities in a sequential manner. Anatomic demonstrations have shown that the anatomical basis of this proposed cerebellar in non-motor function is the existance of cerebro-cerebellar channels (cortico-ponto-cerebellar and cerebellothalamo- cortical loops) that link the cerebellum with motor cortices as well with association cortices and paralimbic regions of the cerebellar hemisphere [2,3]. The clinical studies suggest that whereas the cerebellar anterior lobe is principally engaged in motor control, the cerebellar vermis is involved in affective processing, and the posterior cerebellum contributes to complex cognitive operations [4,5].

Functional MRI studies have revealed activity in the cerebellum during cognitive operations such as sensory discrimination and planning [6,7]. Moreover, PET studies have shown bilateral paravermian activation after verbal repetition of nouns.

We won’t be able to understand this functional heterogeneity, matched by the intricate connectional heterogeneity between different cerebellar regions and the spinal cord, brain stem and cerebral cortex, by a single discipline, even through common diseases. But surely, discovery of such properties will give us new opportunities to detect autism in early years of life. As the brain does the same, we should always find new alterations in the way of thinking.