Opercular Syndrome-MRI

10 year old male child comes with history of seizures with no significant birth history. MRI shows bilateral symmetrical FLAIR hyperintensities which are heterogeneous involving opercular regions with no restriced diffusion or blooming on SWI suggesting bilateral opercular syndrome.

Teaching points by Dr MGK Murthy :

Also called facio-labio-pharyngo-glosso-laryngeal and brachial paralysis or cortical variety of pseudo-bulbar-palsy or Foix – Chavany – Marie syndrome.

Five clinical types:
(a) the classical and most common form associated with cerebrovascular disease.
(b) a subacute form caused by CNS infections.
(c) a developmental form most often related to neuronal migration disorders.
(d) a reversible form in children with epilepsy.
(e) a rare type associated with neurodegenerative disorders.

Can be congenital or acquired, intermitant or persistent.

Characterised by a loss of voluntary control of facial, lingual, pharyngeal and masticatory muscles in the presence of preserved reflexive and automatic functions of the same muscles.