Opercular Syndrome Due to an Unilateral Opercular Infarction

The opercular syndrome is also known as Foix-Chavany-Marie syndrome and also as facio-labio-pharyngo-glosso-laryngo-brachial paralysis or the cortical type of pseudobulbar paralysis. This rare neurological entity generally develops secondary to cerebrovascular accidents affecting the bilateral opercular regions, usually as a result of subsequent strokes. In this paper, we describe a 74-year-old woman who presented with acute onset of inability to speak and swallow. Neurological examination revealed bilateral palsy of lower motor cranial nerves with preservation of reflex and automatic movements. Magnetic resonance images of the brain demonstrated an acute left opercular infarction. This syndrome usually occurs due to bilateral opercular lesions, nevertheless, the typical features of the syndrome may develop as a result of unilateral opercular lesion. (Arc-hi-ves of Neu-ropsy-chi-atry 2012;49: 74-6)