Séquelles psychopathologiques des enfants traités pour tumeur cérébrale

Despite progress during recent years (early detection, chemotherapy, neurosurgery, radiotherapy) the situation of children previously treated for a brain tumour is not satisfactory. Neuropsychological (the main risk factors are mentioned) and psychopathological sequels have negative effects on their schooling and on their social and family situation. All these elements should be taken into account when evaluating these children and when providing them with support (advice given to them, their parents or to their teachers, school guidance, specific rehabilitation, individual or family psychotherapy). Neuropsychological assessment evaluates overall and specific cognitive impairments: the psychotherapy interview assesses the relationship between the child and his/her cancer, the treatment received, possible sequels, child-family and child-sibling relationships, the child's narcissism, his/her body image, thought patterns, plans. The family (social and relational aspects) and the academic situation (relation with the child's teachers) are also appraised. Two clinical cases illustrate the value of this novel approach. They underscore the psychopathological aspects that are poorly apprehended compared to the cognitive or academic ones. The first is a description and account of a 6-year period in Alice's life. Treated for a medulloblastoma at the age of 10, she had sustained memory impairment and found it difficult to preserve a sense of her identity, her relation with her parents, the continuity of her history. The second is an account of Vincent's life over a 6-year period after treatment for a medulloblastoma at the age of 1: he had also sustained cognitive sequels and had a disturbing memory of his cancer and the treatment, of parental conflict and of his mother's confusion. The description of 9 drawings produced by children during the psychotherapeutic interviews shows how diverse and intense their situations, ways of being and thinking and their ability to express themselves can be.