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Rare case of pseudobulbar palsy: subopercular syndrome
Thet Thet Soe1, Navraj Chattha2, Afzal Mahmood2
1Stroke, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK drsoethet@gmail.com.
Abstract:
We present a case of a 73-year-old man who developed sudden onset dysarthria, dysphagia and bilateral facial weakness with automato-voluntary dissociation, which deteriorated rapidly to anarthria and aphonia within a few days. MRI scan of the head showed acute infarct in right internal capsule and an old infarct in the left corona radiata while the rest of the investigations were normal. Based on these findings, diagnosis was thought to be subopercular syndrome. He recovered significantly in a few weeks' time.
Insights
A 73-year-old man experienced sudden speech and swallowing difficulties, facial weakness, and loss of voice. Diagnosis of subopercular syndrome was made, with significant recovery observed within weeks.
Area of Science:
- Neurology
- Neuroscience
- Clinical Medicine
Background:
- Subopercular syndrome is a rare neurological condition affecting speech and facial motor control.
- Understanding the clinical presentation and neuroimaging findings is crucial for diagnosis.
Observation:
- A 73-year-old male presented with acute onset dysarthria, dysphagia, and bilateral facial weakness.
- Symptoms rapidly progressed to anarthria and aphonia over a few days.
- Automato-voluntary dissociation of facial movements was noted.
Findings:
- Cerebral MRI revealed an acute infarct in the right internal capsule and a chronic infarct in the left corona radiata.
- Other investigations were within normal limits.
- The clinical presentation and imaging findings supported a diagnosis of subopercular syndrome.
Implications:
- This case highlights the importance of recognizing subopercular syndrome based on specific clinical and radiological features.
- Prompt diagnosis and management can lead to significant patient recovery.
- Further research into the pathophysiology and treatment of subopercular syndrome is warranted.
