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NEUROLOGY 2008;70:e88
© 2008 American Academy of Neurology
Resident and Fellow Section

Teaching Video NeuroImage: Foix–Chavany–Marie syndrome

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Peter L. Konieczny, MD, Benjamin H. Eidelman, MD, PhD and William D. Freeman, MD

From the Department of Neurology, Mayo Clinic, Jacksonville, FL.

Address correspondence and reprint requests to Dr. William D. Freeman, Department of Neurology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224 freeman.william1{at}mayo.edu

A 79-year-old woman with a history of prior right frontal infarction presented with sudden inability to speak (figure, A). Examination revealed anarthria, yet intact comprehension, writing, and limb function (video). Voluntary tongue, swallowing, and mouth movements were absent, while cough and swallow reflexes were preserved (video). An acute left hemispheric ischemic stroke causing Foix-Chavany-Marie syndrome (FCMS) was diagnosed, and IV recombinant tissue plasminogen activator was administered. Left frontal infarction was confirmed on MRI (figure, B).


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  		Figure (A) CT scan without contrast showing area of old right-sided infarct encompassing the frontoparietal opercular cortex; (B) diffusion-weighted MRI with restricted diffusion in the left precentral gyrus

 

FCMS involves lesions of the bilateral frontal operculum1 or the cortical-subcortical areas of primary motor cortex.2 Voluntary control of facio-pharyngo-glosso-masticatory muscles is lost, while reflex movements and limb strength are preserved.

Supplemental data at www.neurology.org

Disclosure: The authors report no disclosures.


   REFERENCES
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 REFERENCES
 

  1. Foix C, Chavany J-A, Marie J. Diplégie facio-linguo-masticatrice d’origine cortico sous-corticale sans paralysie des membres (contribution à l’étude de la localisation des centres de la face du membre supérieur), par MM. Rev Neurol 1926;33:214–219.
  2. Weller M. Anterior opercular cortex lesions cause dissociated lower cranial nerve palsies and anarthria but no aphasia: Foix-Chavany-Marie syndrome and "automatic voluntary dissociation" revisited. J Neurol 1993;240:199–208.[Medline]




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