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.