Ischemic Bilateral Opercular Syndrome

Abstract

Opercular syndrome, also known as Foix-Chavany-Marie syndrome, is a paralysis of the facial, pharyngeal, masticatory, tongue, laryngeal, and brachial muscles. It is a rare cortical form of pseudobulbar palsies caused by vascular insults to bilateral operculum. Its clinical presentations include anarthria, weakness of voluntary muscles involving face, tongue, pharynx, larynx, and masticatory muscles. However, autonomic reflexes and emotional activities of these structures are preserved. In the present case, an 81-year-old male presented with acute onset of anarthria with difficulties in chewing, speaking, and swallowing that was diagnosed with opercular syndrome.

Bilateral Anterior Opercular Syndrome With Partial Kluver–Bucy Syndrome in a Stroke Patient: A Case Report

“…This syndrome is characterized by the loss of the voluntary movement of the facial and tongue muscles with a preserved reflex movement in these muscles, anarthria with preserved writing skills, and the absence of limb weakness. Automatic-voluntary dissociation occurs because the voluntary control of facial and tongue muscles is supplied by the primary motor cortex and the pyramidal tract, whereas the extrapyramidal tract, the thalamus, and the hypothalamus supply emotional and spontaneous control [ 7 8 ].…”

Opercular myoclonic-anarthric status epilepticus: A report of two cases

“…The syndrome consists of anarthria, bilateral volitional paresis of the facial, lingual, pharyngeal and masticatory muscles, with preservation of the reflexive, emotional and automatic innervations of the same muscles. [ 9 10 ] This results mostly from bilateral anterior opercular lesion and sometimes unilateral opercular lesion due to cerebrovascular accident. [ 10 ] It was not present in both of our cases because they voluntarily move facial, lingual and pharyngeal muscles.…”

“…[ 9 10 ] This results mostly from bilateral anterior opercular lesion and sometimes unilateral opercular lesion due to cerebrovascular accident. [ 10 ] It was not present in both of our cases because they voluntarily move facial, lingual and pharyngeal muscles. Bilateral clonic involvement of face and jaw occurring with true FCMS has been reported.…”

Bilateral anterior opercular syndrome

“…4 It is usually seen in adults. It can result from tumour or infection but is mainly due to successive strokes involving both opercular regions.…”