Foix-Chavany-Marie syndrome (FCMS) or bilateral opercular syndrome (OPS) is a rare pseudobulbar palsy characterized by facial, lingual, pharyngeal, and masticatory voluntary muscle paralysis resulting in anarthria with preservation of autonomic, involuntary, and reflexive functions. Damage to the posterior part of the inferior frontal gyrus and inferior part of precentral gyrus play a role in the pathogenesis of FCMS. We report a rare case of bilateral OPS following an acute right middle cerebral artery (MCA) infarct in a patient with history of glioblastoma, and resection in the left MCA territory within the cingulate gyrus, showing recovery of speech and swallowing despite intensive bilateral opercular lesions owing to extensive multidisciplinary team support. However, the patient was discharged with a percutaneous endoscopic gastrostomy tube for long-term enteral feeding support due to partial recovery. The patient's history of glioblastoma, left MCA cingulate gyrus resection and right MCA infarction with automatic-voluntary dissociation led to the diagnosis of FCMS. Rehabilitation surprisingly showed mild improvement in speech and swallowing despite extensive bilateral opercular lesions proving that there are still chances of improvement in speech and swallowing in OPS with the right multidisciplinary approach. Patients with a history of brain tumours like glioblastoma can develop bilateral OPS later in life in case of other vascular events that cause lesions in a previously unaffected operculum, triggering symptoms. Extensive involvement of the speech and language team is of significant in the management of FCMS cases as above where some recovery might still be seen. Foix-Chavany-Marie syndrome (FCMS) can be caused by bilateral opercular lesions (new or old or a combination of both) in patients with history of high-grade brain tumours.Patients with bilateral opercular syndrome experience full or partial or no recovery at all of speech and swallowing, hence proper rehabilitation with a Speech and Language Team is significant.Understanding automatic-voluntary dissociation in FCMS and being able to differentiate it from bulbar palsy and other similar phenomena is crucial in making a diagnosis of FCMS.

Anterior opercular syndrome (a.k.a. Foix-Chavany-Marie syndrome) is a rare neurological condition, described as a paralysis of the mouth and tongue usually caused by a bilateral lesion of the frontal opercular area. The patient presents with speaking, chewing, and swallowing impairment, but autonomic and emotional functions-like smiling and yawning-are typically preserved. We present our patient's clinical data after critical analysis, together with a brief literature review about anterior opercular syndrome caused by unilateral opercular lesions. To our knowledge, less than 20 cases of anterior opercular syndrome caused by unilateral lesions are described in the literature. In some patients, a contralateral lesion can be detected on brain imaging in regions different from the anterior opercular cortex. This syndrome can rarely occur as a consequence of unilateral opercular cortex damage. The possible role of contralateral lesions located in neuronal pathways functionally related to the anterior operculum requires further investigation.

Anterior Opercular Syndrome, or Foix-Chavany-Marie Syndrome (FCMS), is a rare pseudobulbar palsy that severely impacts speech and swallowing due to orofacial muscle weakness. Limited research exists on therapeutic approaches targeting motor speech deficits in this condition. This case study aimed to evaluate the efficacy of speech based oromotor exercises in improving speech intelligibility and oromotor control in a 20-year-old male with FCMS. A personalized therapy regimen emphasizing the strength and mobility of jaw, lip, and tongue and exercises to improve intraoral pressure was implemented thrice weekly over three weeks. Progress was systematically recorded using the domains of Frenchay Dysarthria Assessment. Steady improvements in articulatory precision, speech clarity, and specific oromotor functions were observed, with significant gains in intelligibility was observed. However, slow progress was noted in tongue lateralization and intraoral pressure. This study demonstrates the potential of structured speech-based oromotor therapy to enhance speech outcomes in FCMS, offering a foundation for further research into targeted therapeutic models for this rare condition.

Foix-Chavany-Marie syndrome, also known as opercular syndrome, is a rare neurological condition typically caused by bilateral lesions of the opercular cortex. Involvement of arachnoid cysts in the pathogenesis is extremely uncommon. We report the case of a 66-year-old male who presented with sudden-onset dysarthria, dysphagia, and bilateral lower facial paralysis, but retained the ability to yawn and smile, demonstrating the characteristic dissociation between voluntary and involuntary orofacial movements. Magnetic resonance imaging revealed an acute infarction in the left corona radiata and a right-sided arachnoid cyst, leading to a diagnosis of Foix-Chavany-Marie syndrome. This case highlights a classic presentation of Foix-Chavany-Marie syndrome with a potentially novel pathogenic contribution from an arachnoid cyst.

Foix Chavany Marie syndrome (FCMS), or opercular syndrome, is a rare type of pseudobulbar palsy characterized by paralysis of bilateral facio-linguovelo-masticatory and pharyngeal muscles with automatic-voluntary dissociation. This syndrome was first described by Magnus in 1837 and further defined by two French neurologists, Charles Foix and Jean Alfred Emile Chavany, along with one French pediatrician, Julie Marie, who reported it first in 1926. Since then, a few cases have been reported across the world. We hereby report a case of FCMS in a 61-year-old male patient who presented to us with two different cerebrovascular events.