Reversible Foix-Chavany-Marie syndrome after right operculo-insular contusion from a spear gun trauma through the cranial base

Abstract Background and object Foix-Chavany-Marie syndrome (FCMS) is a rare type of pseudobulbar palsy, which is characterized by anarthria or severe dysarthria and bilateral central facio-linguo-velo-pharyngo-mastigatory paralysis with “automatic voluntary dissociation”. We report on a patient who suffered a reversible FCMS following a spear gun trauma through the cranial base leading to right operculo-insular contusion. Case Report This 28-year-old lady attempted suicide by shooting a spear gun into the head through her right submandibular region. Major vessel injury was ruled out and the patient was taken to the operating room for shaft removal. Postoperatively, we observed the mouth half open, drooling saliva, inability to move her tongue, anarthria, bilateral facial weakness, and loss of the gag reflex. Yawning was otherwise preserved resulting in a clinical diagnosis of FCMS. Postoperative imaging demonstrated a right operculoinsular contusion. Symptoms were fully recovered after two years of follow-up. Conclusion FCMS is a rare and severe form of pseudobulbar palsy. Unilateral lesions are exceptional but should be recognized, as we presented. Generally, the outcome is moderate to poor but the occurrence in brain trauma can be associated with complete functional recovery.