Anarthria and bilateral central faciolinguopharyngeomasticatory paralysis with automatic voluntary dissociation are the clinical hallmarks of Foix-Chavany-Marie syndrome (FCMS), the cortico-subcortial type of suprabulbar palsy. We present a 64-year-old man who was admitted due to acute onset of speechlessness for days. Neurological examinations demonstrated typical features of FCMS. Cranial MRI showed a right opercular lesion and several lacunar infarcts in bilateral hemispheres. Hexamethylpropylenamine oxime (HMPAO) brain SPECT revealed hypoperfusion in bilateral opercular regions and notably on the right side. In review of previous reports, the most common etiology of FCMS is stroke in the region of either operculum. Our case may be a good example of FCMS after multiple cerebrovascular insults over bilateral opercular cortico-subcortical areas as demonstrated in MRI and SPECT studies.
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