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Neurological Rehabilitation

A Rare Case of Separate Cerebrovascular Accidents Resulting in Foix-Chavany-Marie Syndrome

Friday, October 24, 2025
12:00 PM - 1:30 PM MT
Location: Kiosk 6

    Poster Presenter(s)

  • Sophia Antimisiaris, DO

    Resident Physician
    Burke Rehabilitation Hospital PM&R Program
    White Plains, New York

    • Co-Author(s)

  • Siam Ayon, DO

    Resident Physician
    New York Presbyterian Queens, Burke Rehabiliation Hospital
    Hollis, New York

  • Mery Elashvili, MD DO

    Director of stroke rehabilitation service. DIO
    3473534004
    Forest Hills, New York

Disclosure(s):
Sophia Antimisiaris, DO: No financial relationships to disclose
Siam Ayon, DO: No financial relationships to disclose
Mery Elashvili, MD DO: No financial relationships to disclose
Case Diagnosis: 73 year-old female with prior left middle cerebral artery (MCA) stroke presented with acute left-sided weakness, aphasia, and dysarthria found to have an acute right MCA and opercular infarct resulting in Foix-Chavany-Marie Syndrome (FCMS).

Case Description or Program Description: CTA of the head revealed a distal M2 occlusion for which TNK was administered. The evening of admission, the patient required intubation for acute hypoxic respiratory failure. Repeat CT of the head showed a right MCA CVA along with an evolving right opercular infarct. The patient was diagnosed with FCMS, ultimately requiring percutaneous endoscopic gastrostomy (PEG) tube placement for severe oropharyngeal dysphagia. Once extubated and medically stable, she was discharged to an acute inpatient rehabilitation (AIR) center for further care.

Setting: Acute Inpatient Rehabilitation Facility

Assessment/Results: The patient arrived to AIR with residual right spastic hemiplegia from her previous stroke, severe oropharyngeal dysphagia with PEG tube in place, severe expressive aphasia, and requiring oxygen supplementation via nasal cannula. The patient made significant progress through aggressive therapy focusing on speech therapy, and was ultimately upgraded to an oral diet prior to her discharge from AIR.

Discussion (relevance): Foix-Chavany-Marie Syndrome (FCMS) is a rare neurological condition involving loss of control over facial, tongue, pharyngeal, and masticatory muscles due to bilateral lesions in the anterior opercular regions of the brain resulting in bilateral cortical-subcortical pseudobulbar palsy of the lower cranial nerves V, VII, IX, and XII. In this case, the patient had an acute stroke affecting the right opercular region of the brain in the setting of a suspected chronic left opercular region infarct from her previous stroke, ultimately leading to bilateral involvement and thus progressing to FCMS.

Conclusions: While FCMS is rare, it should be considered in cases of bilateral cerebrovascular accidents regardless of when each infarct occurred. Early recognition, diagnosis, and rehabilitation are imperative for improved outcomes in recovery.