INTRODUCTION
Opercular syndrome (OPS)-Foix-Chavany-Marie Syndrome (FCMS) is a rarely seen cortical type of pseudobulbar palsy that is characterized by paralysis of facial, lingual, pharyngeal, and masticatory voluntary muscles with preservation of autonomic, involuntary, and reflexive functions leading to automatic–voluntary dissociation.(1) It has a prevalence of <1/1,000,000.(2) Those muscles that are voluntarily paralysed are well preserved in autonomic, reflexive and emotional domains, which means that the corneal reflex, the threaten reflex, and emotional laughing or crying are all possible.(3)(4)
The anatomic basis for such a dissociation has been linked to the presence of alternate pathways connecting the amygdala and hypothalamus to the brainstem controlling reflexive and automatic muscle action.(5) FCMS is most commonly secondary to bilateral sequential anterior opercular or subcortical insular infarcts.(6)
Few cases have been reported of opercular syndrome with viral infection such as Herpes simplex virus.(2)(7)
Here we present a case of herpes simplex virus infection induced bilateral opercular syndrome in a male patient.