ABSTRACT
Five cases of “bilateral opercular syndrome” of vascular etiology are reported. Cortical pseudobulbar palsy (i.e. spastic anarthria and inability to swallow) with dissociation of automatic voluntary movements in the affected muscles are the essential features of this syndrome. Additional motor and sensory symptoms differentiate its subtypes. All 5 patients had bilateral opercular syndrome. The unusual features was its occurrence as the presenting feature of preeclampsia in a young lady, and the development of the transient syndrome following a right focal seizure with generalization at high altitude in a young female trekker who had an old unilateral infarct in left opercular region. Whereas the limb motor weakness recovered well, the recovery was unsatisfactory for speech and for swallowing.