A Rare Case Report of Neuroimaging, Electrophysiological, and Dynamic Laryngoscopy Studies in a Stroke Patient of Foix-Chavany-Marie Syndrome.

Researchers described a rare stroke case involving a patient with Foix-Chavany-Marie Syndrome (FCMS), a neurological condition that affects voluntary facial and swallowing movements while preserving automatic expressions like laughing and crying. The patient experienced facial paralysis, difficulty speaking and swallowing, difficulty closing the eyelids voluntarily, and a mask-like facial expression due to strokes affecting both sides of the brain—one recent and one older. The syndrome occurs when specific brain regions called the operculum are damaged by stroke.

Doctors used multiple diagnostic tools including MRI brain scans, nerve conduction studies (blink reflex testing), and dynamic laryngoscopy to examine swallowing function. The testing revealed that while the brainstem pathways remained intact, the nerve pathways connecting the brain's cortex to facial muscles were impaired. The patient showed severe problems with the mouth and throat phases of swallowing.

The treatment approach combined multiple therapies, including acupuncture and swallowing training exercises. This multimodal treatment plan led to significant improvements in the patient's condition. Notably, the problems with eyelid control completely resolved, and the patient achieved a relatively good overall recovery.

For patients with stroke-related swallowing and facial movement disorders, this case suggests that acupuncture may be a valuable component of a comprehensive rehabilitation program when combined with conventional therapies. Early diagnosis and prompt initiation of combined treatments appear important for optimal outcomes. Patients interested in acupuncture for stroke rehabilitation should seek care from a licensed acupuncturist experienced in neurological conditions.

This case report documents a stroke patient with Foix-Chavany-Marie Syndrome (FCMS) presenting with bilateral opercular involvement—an acute right frontal-parietal cortical lesion and remote left lateral paraventricular infarction. Clinical manifestations included masked facies, bilateral facial paralysis, dysarthria, dysphagia, and eyelid closure apraxia, with preserved automatic emotional expressions. MRI confirmed acute and chronic contralateral opercular lesions. Electrophysiological assessment (blink reflex) demonstrated intact brainstem pathways but impaired corticobulbar tracts. Dynamic laryngoscopy revealed severe oral and pharyngeal phase dysphagia. The patient received multimodal treatment incorporating acupuncture and swallowing rehabilitation. Outcomes included complete resolution of eyelid motor deficits and significant functional improvement overall, with relatively good prognosis. This case demonstrates acupuncture's potential role within comprehensive stroke rehabilitation for FCMS, particularly when initiated early. The multimodal approach addressing both voluntary movement disorders and bulbar dysfunction proved effective in this autonomic-voluntary dissociation syndrome.