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Unilateral opercular lesion mimicking opercular syndrome

2021; Medical Association of São Paulo; Linguagem: Inglês

10.5327/1516-3180.601

1806-9460

João Nicoli Ferreira dos Santos, Izadora Fonseca Zaiden Soares, Lis Gomes Silva,

Cleft Lip and Palate Research

Introduction: Foix-Chavany-Marie syndrome, also known as opercular syndrome, consists of voluntary orofacial muscle paralysis due to bilateral lesions in the anterior frontotemporal operculum. Classically, there is an automatic-voluntary dissociation, with impairment of speech and chewing. We present a case of a patient who had a similar presentation to opercular syndrome, secondary to unilateral ischemic lesion in the right frontal operculum. Case report: A 55-year-old, right-handed, black woman with history of arterial hypertension was admitted to the emergency department presenting left-sided weakness and inability to speak, noticed upon waking. When approached, the patient was unable to produce sounds but managed to communicate through articulatory movements of lips and was able to write correctly without signs of aphasia. On examination, there was left central facial paralysis, marked reduction in mouth opening amplitude, inability to perform tongue protrusion without lateral deviation and bilateral reduction in palate elevation. There was also a mild left brachial- predominant hemiparesis (grade IV). A cranial computed tomography scan exhibited an acute ischemic lesion of the right frontal opercular region, without other lesions in the homologous contralateral area. The etiological investigation with electrocardiogram, echocardiogram and carotid doppler ultrasound had no significant abnormalities. Conclusion: We reported a case of a patient presenting with aphonia and bulbar musculature paresis due to a right unilateral frontal opercular lesion, mimicking the opercular syndrome presentation.