Opercular syndrome (Foix–Chavany–Marie syndrome) secondary to corona radiata stroke and polymicrogyria: A case report

Foix–Chavany–Marie syndrome (FCMS), or anterior opercular syndrome, is a rare form of orofacial paralysis that results from bilateral damage to the operculum involving the corticobulbar fibers of cranial nerves 5, 7, 9, 10, and 12. It manifests as paralysis in the voluntary movements performed by the facial, pharyngeal, lingual, and masticatory muscles, but with preserved reflexive movements involving the same group of muscles. This phenomenon is termed automatic-voluntary dissociation, a classical clinical feature observed in FCMS. We report the case of a 61-year-old man who developed an acute onset of anarthria and dysphagia. The clinical presentation, imaging findings, and preserved reflexive orofacial movements guided the final diagnosis. This case highlights a rare presentation of a disconnection syndrome involving corticobulbar pathways, emphasizing the importance of clinico-neuroradiological correlation in diagnosing FCMS in acute unilateral brain lesions.