Journal Mobile

N Gordon
Journal Issue: 
Volume 37: Issue 2: 2007




The opercular syndrome is due to bilateral, and sometimes unilateral, lesions of this area of the cerebral cortex, or its connections with the brain stem. The  symptoms  and  signs  of  the  syndrome  are  described, especially  the  type  of facial  palsy.   They  differ  slightly  in  childhood,  and  may  be  accompanied  by developmental delay. They can be reversible when linked to epileptic activity in the opercular  areas.    The  symptoms  can  be  suggestive  of  two  well-established syndromes  in  childhood.  Firstly, the  Landau–Kleffner  syndrome  (and  there  may well be shared pathophysiological mechanisms) and secondly, those first described by Worster–Drought.

The  investigations  needed  to  establish  the  location  and  the  possible  causes  of  the opercular syndrome are discussed.  The most common causes are vascular lesions, but  other  possibilities  such  as  infections  and  trauma  have  to  be  considered.  Also malformations of prenatal origin can result in the suprabulbar palsy so typical of the syndrome. If the cause can be established there is always the possibility of treatment.