A Case of Bilateral Anterior Opercular Syndrome: Foix-Chavany-Marie Syndrome

ABSTRACT

Bilateral opercular syndrome or Foix-Chavany-Marie syndrome (FCMS) is characterized by facio-pharyngo-glosso-masticatory diplegia with an automatic-voluntary movement dissociation, which is usually caused by bilateral fron-toparietal opercular lesions. A 52 year-old man suddenly developed left hemiplegia and also presented with anarthria, dysphagia, difficulty in jaw opening and mastication. However, involuntary swallowing and slight control of jaw move-ments were partly preserved. His gag reflex was decreased and emotional incontinence was absent. Brain magnetic res-onance (MR) imaging revealed high signal lesions in the right middle cerebral artery territory and left anterior opercu-lum. Severe stenosis of the right middle cerebral artery was observed on a MR angiogram. Rehabilitation training by cueing has improved his ability to open the mouth. To our knowledge, this is the first report of FCMS in Korea, and a cautious differential diagnosis of pseudobulbar palsy or buccofacial apraxia may be crucial.