Importance of Rapid Clinical Recognition of the Anterior Opercular Syndrome (Foix-Chavany-Marie Syndrome): A Case Report

Abstract

We have described a 55-year-old woman with the anterior opercular syndrome (Foix-Chavany-Marie syndrome). The clinical presentation included acute onset of bilateral facial palsy and anarthria. Immediate MRI of the brain revealed acute ischemia in the right opercular region and sequelae after a previous infarction involving the left opercular region. The patient was treated with intravenous thrombolysis resulting in full recovery. The anterior opercular syndrome is rare, and the most common reason is sequential stroke. We emphasize the importance of recognizing this syndrome early, and in all cases, consulting a revascularization center immediately.

A Case of Foix-Chavany-Marie Syndrome With Asynchronous Bilateral Opercular Infarcts and Chronic Bilateral Cerebellar Infarcts

“…Foix-Chavany-Marie syndrome (FCMS), also known as anterior opercular syndrome, is a rare neurological condition that presents with voluntary facial, pharyngeal, lingual, and masticatory paralysis bilaterally [ 1 ]. Patients typically present with acute-onset facial weakness, dysphagia, and dysarthria or anarthria while maintaining the involuntary ability to yawn, smile, laugh, and cry [ 2 , 3 ]. This syndrome was first described by Magnus in 1837 and further defined by Foix, Chavany, and Marie in 1926 after whom the condition was later named [ 4 ].…”

“…FCMS is commonly caused by ischemic lesions [ 1 - 4 ]; however, it has also been reported in patients with cerebral infection [ 5 - 7 ], demyelinating disease [ 8 ], trauma [ 9 ], tumor [ 10 ], hydrocephalus [ 11 ], and osmotic demyelination syndrome [ 12 ]. There have been less than 150 cases of FCMS noted in the literature, and less than 40 cases of which have been caused by ischemic stroke; however, FCMS is being increasingly reported due to advances in computed tomography (CT) and magnetic resonance imaging (MRI) [ 3 , 4 ].…”