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KMID : 1024720190090020048
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Geriatric Rehabilitation
2019 Volume.9 No. 2 p.48 ~ p.52
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The Cause of Dyspahgia Using Transcranial Magnetic Stimulation (TMS) for in a Patient with Bilateral Opercular Syndrome
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Lim Ju-Young
Yoo Young-Hwan
Park Chan-Hyuk
Joa Kyung-Lim
Kim Chang-Hwan
Kim Myeong-Ok
Jung Han-Young
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Abstract
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Opercular syndrome is facio-labio-pharyngo-glosso-masticatory paralysis without hemiplegia. This syndrome was produced by affection of cortical or subcortical lesions of the operculum or its connections on both sides of the brain. We report a case that used the Transcranial Magnetic Stimulation (TMS) in patient with opercular syndrome to determine the cause of dysphagia. A 60-year-old woman was admitted to hospital with sudden onset of dysarthria, dysphagia, and left side weakness. Brain MRI findings showed acute infarction in right middle cerebral artery(MCA) territory and encephalomalacia in left parietotemporal lobe and frontal lobe by the previous srtoke. The result of Videofluoroscopic swallowing study for dysphagia showed poor bolus formation and delayed oral transit time due to clumsy tongue movement. Despite of oromotor rehabilitation, there was no improvement on oromotor function. The patient underwent TMS to determine the cause of oromotor disturbance, and the abnormal motor evoked potential at both mylohyoid muscle was shown. This meant the damage of corticobulbartract. As a result, we found dysphagia induced by damage of bilateral corticobulbar tract in a patient with bilateral MCA infaction.
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KEYWORD
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Bilateral opercular syndrome, TMS, Dysphagia
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