Short communication| Volume 276, ISSUE 1-2, P193-195, January 15, 2009

Isolated facio-lingual hypoalgesia and weakness after a hemorrhagic infarct localized at the contralateral operculum


      Isolated facio-lingual hypoesthesia and weakness is rare. We describe a case of isolated facio-lingual hypoesthesia and weakness after a hemorrhagic infarct localized at the contralateral operculum. A 66-year-old woman developed acute onset of facio-lingual hypoalgesia, hypoesthesia, and weakness, with no such symptoms being observed in other parts of the body. Brain magnetic resonance imaging showed a subacute hemorrhagic infarct in the right frontal operculum, which spread slightly to the right temporo-parietal operculum. 123IMP-SPECT showed hypoperfusion in the right fronto-temporo-parietal operculum, as detected by MRI, without apparent diaschisis within the brain. Neuroimaging findings for our patient suggested the involvement of the primary somatosensory-motor cortices (S1 and M1) and the secondary somatosensory cortex (S2), which receive trigemino-thalamo-cortical pathways.


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        • Kamitani T.
        • Kuroiwa Y.
        • Hidaka M.
        Isolated hypesthesia in the right V2 and V3 dermatomes after a midpontine infarction localised at an ipsilateral principal sensory trigeminal nucleus.
        J Neurol Neurosurg Psychiatry. 2004; 75: 1504-1509
        • Iwasaki Y.
        • Kinoshita M.
        • Ikeda K.
        • Takamiya K.
        • Shiojima T.
        Oral syndrome: an incomplete form of cheiro-oral syndrome?.
        Int J Neurosci. 1991; 58: 271-273
        • Kim J.S.
        Pure dysarthria, isolated facial paresis, or dysarthria-facial paresis syndrome.
        Stroke. 1994; 25: 1994-1998
        • Urban P.P.
        • Wicht S.
        • Hopf H.C.
        • Fleischer S.
        • Nickel O.
        Isolated dysarthria due to extracerebellar lacunar stroke: a central monoparesis of the tongue.
        J Neurol Neurosurg Psychiatry. 1999; 66: 495-501
        • Posteraro L.
        • Pezzoni F.
        • Varalda E.
        • Fugazza G.
        • Mazzucchi A.
        A case of unilateral opercular syndrome associated with a subcortical lesion.
        J Neurol. 1991; 238: 337-339
        • Fox R.J.
        • Kasner S.E.
        • Chatterjee A.
        • Chalela J.A.
        Aphemia: an isolated disorder of articulation.
        Clin Neurol Neurosurg. 2001; 103: 123-126
        • Maeder-Ingvar M.
        • van Melle G.
        • Bogousslavsky J.
        Pure monoparesis: a particular stroke subgroup?.
        Arch Neurol. 2005; 62: 1221-1224
        • Kumral E.
        • Celebisoy M.
        • Celebisoy N.
        • Canbaz D.H.
        • Calli C.
        Dysarthria due to supratentorial and infratentorial ischemic stroke: a diffusion-weighted imaging study.
        Cerebrovasc Dis. 2007; 23: 331-338
        • Hirayama K.
        • Fukutake T.
        • Kawamura M.
        Thumb localizing test for detecting a lesion in the posterior column-medial lemniscal system.
        J Neurol Sci. 1999; 167: 45-49
        • 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
        • Lotze M.
        • Erb M.
        • Flor H.
        • Huelsmann E.
        • Godde B.
        • Grodd W.
        fMRI evaluation of somatotopic representation in human primary motor cortex.
        Neuroimage. 2000; 11: 473-481
        • Hiraga A.
        • Sakakibara R.
        • Mizobuchi K.
        • Asahina M.
        • Kuwabara S.
        • Hayashi Y.
        • et al.
        Putaminal hemorrhage disrupts thalamocortical projection to secondary somatosensory cortex: case report.
        J Neurol Sci. 2005; 231: 81-83
        • Bogousslavsky J.
        • Dizerens K.
        • Regli F.
        • Despland P.A.
        Opercular cheiro-oral syndrome.
        Arch Neurol. 1991; 48: 658-661
        • Cerf-Ducastel B.
        • Van de Moortele P.F.
        • MacLeod P.
        • Le Bihan D.
        • Faurion A.
        Interaction of gustatory and lingual somatosensory perceptions at the cortical level in the human: a functional magnetic resonance imaging study.
        Chem Senses. 2001; 26: 271-383
        • Eickhoff S.B.
        • Grefkes C.
        • Zilles K.
        • Fink G.R.
        The somatotopic organization of cytoarchitectonic areas on the human parietal operculum.
        Cereb Cortex. 2007; 17: 1800-1811
        • Jack Jr, C.R.
        • Thompson R.M.
        • Butts K.
        • Sharbrough F.W.
        • Kelly P.J.
        • Hanson D.P.
        • et al.
        Sensory motor cortex: correlation of presurgical mapping with functional MR imaging and invasive cortical mapping.
        Radiology. 1994; 190: 85-92