nach oben

Erschienen in:

09.11.2019 | Case Report

Postoperative isolated lower extremity supplementary motor area syndrome: case report and review of the literature

verfasst von: Nardin Samuel, Brian Hanak, Jerry Ku, Ali Moghaddamjou, Francois Mathieu, Mahendra Moharir, Michael D. Taylor

Erschienen in: Child's Nervous System | Ausgabe 1/2020

Einloggen, um Zugang zu erhalten

Abstract

The supplementary motor area (SMA) syndrome is characterized by transient weakness and akinesia contralateral to the side of the affected hemisphere. The underlying pathology of the syndrome is not fully understood but is thought to be related to lesions in the SMA, residing principally in the mesial superior frontal gyrus (Broadmann’s area 6c). Although the SMA syndrome a well-characterized clinical entity, we report herein, to our knowledge, the first case of isolated lower extremity SMA syndrome in the literature. This case highlights the importance of considering this rare clinical entity in the context of new or worsening postoperative neurologic deficits. Moreover, early studies did not support somatotopic organization of the SMA as in the primary motor cortex; emerging evidence suggests that delicate somatotopic representation may underlie distinct presentations like that reported in the present case.

Penfield W, Welch K (1951) The supplementary motor area of the cerebral cortex; a clinical and experimental study. AMA Arch Neurol Psychiatry 66:289–317CrossRef

Bancaud J, Talairach J (1967) Functional organization of the supplementary motor area. Data obtained by stereo-E.E.G. Neurochirurgie 13:343–356PubMed

Lim SH, Dinner DS, Pillay PK, Luders H, Morris HH, Klem G, Wyllie E, Awad IA (1994) Functional anatomy of the human supplementary sensorimotor area: results of extraoperative electrical stimulation. Electroencephalogr Clin Neurophysiol 91:179–193CrossRef

Penfield W (1950) The supplementary motor area in the cerebral cortex of man. Arch Psychiatr Nervenkr Z Gesamte Neurol Psychiatr 185:670–674CrossRef

Laplane D, Talairach J, Meininger V, Bancaud J, Orgogozo JM (1977) Clinical consequences of corticectomies involving the supplementary motor area in man. J Neurol Sci 34:301–314CrossRef

Berger MS, Kincaid J, Ojemann GA, Lettich E (1989) Brain mapping techniques to maximize resection, safety, and seizure control in children with brain tumors. Neurosurgery 25:786–792CrossRef

Krieg SM, Shiban E, Droese D, Gempt J, Buchmann N, Pape H, Ryang YM, Meyer B, Ringel F (2012) Predictive value and safety of intraoperative neurophysiological monitoring with motor evoked potentials in glioma surgery. Neurosurgery 70:1060–1070; discussion 1070-1061. https://doi.org/10.1227/NEU.0b013e31823f5ade CrossRefPubMed

Nakajima R, Nakada M, Miyashita K, Kinoshita M, Okita H, Yahata T, Hayashi Y (2015) Intraoperative motor symptoms during brain tumor resection in the Supplementary Motor Area (SMA) without positive mapping during awake surgery. Neurol Med Chir (Tokyo) 55:442–450. https://doi.org/10.2176/nmc.oa.2014-0343 CrossRef

Yamane F, Muragaki Y, Maruyama T, Okada Y, Iseki H, Ikeda A, Homma I, Hori T (2004) Preoperative mapping for patients with supplementary motor area epilepsy: multimodality brain mapping. Psychiatry Clin Neurosci 58:S16–S21. https://doi.org/10.1111/j.1440-1819.2004.01244_5.x CrossRefPubMed

10.

Van Buren JM, Fedio P (1976) Functional representation on the medial aspect of the frontal lobes in man. J Neurosurg 44:275–289. https://doi.org/10.3171/jns.1976.44.3.0275 CrossRefPubMed

11.

Aizawa H, Inase M, Mushiake H, Shima K, Tanji J (1991) Reorganization of activity in the supplementary motor area associated with motor learning and functional recovery. Exp Brain Res 84:668–671CrossRef

12.

Duffau H, Lopes M, Denvil D, Capelle L (2001) Delayed onset of the supplementary motor area syndrome after surgical resection of the mesial frontal lobe: a time course study using intraoperative mapping in an awake patient. Stereotact Funct Neurosurg 76:74–82. https://doi.org/10.1159/000056496 CrossRefPubMed

13.

Kasasbeh AS, Yarbrough CK, Limbrick DD, Steger-May K, Leach JL, Mangano FT, Smyth MD (2012) Characterization of the supplementary motor area syndrome and seizure outcome after medial frontal lobe resections in pediatric epilepsy surgery. Neurosurgery 70:1152–1168; discussion 1168. https://doi.org/10.1227/NEU.0b013e31823f6001 CrossRefPubMed

14.

Alonso-Vanegas MA, San-Juan D, Buentello Garcia RM, Castillo-Montoya C, Senties-Madrid H, Mascher EB, Bialik PS, Trenado C (2017) Long-term surgical results of supplementary motor area epilepsy surgery. J Neurosurg 127:1153–1159. https://doi.org/10.3171/2016.8.JNS16333 CrossRefPubMed

15.

Potgieser AR, de Jong BM, Wagemakers M, Hoving EW, Groen RJ (2014) Insights from the supplementary motor area syndrome in balancing movement initiation and inhibition. Front Hum Neurosci 8:960. https://doi.org/10.3389/fnhum.2014.00960 CrossRefPubMedPubMedCentral

16.

Chivukula S, Pikul BK, Black KL, Pouratian N, Bookheimer SY (2018) Contralateral functional reorganization of the speech supplementary motor area following neurosurgical tumor resection. Brain Lang 183:41–46. https://doi.org/10.1016/j.bandl.2018.05.006 CrossRefPubMedPubMedCentral

17.

Russell SM, Kelly PJ (2003) Incidence and clinical evolution of postoperative deficits after volumetric stereotactic resection of glial neoplasms involving the supplementary motor area. Neurosurgery 52:506–516 discussiom 515-506CrossRef

18.

von Lehe M, Wagner J, Wellmer J, Clusmann H, Kral T (2012) Epilepsy surgery of the cingulate gyrus and the frontomesial cortex. Neurosurgery 70:900–910; discussion 910. https://doi.org/10.1227/NEU.0b013e318237aaa3 CrossRef

19.

Kim YH, Kim CH, Kim JS, Lee SK, Han JH, Kim CY, Chung CK (2013) Risk factor analysis of the development of new neurological deficits following supplementary motor area resection. J Neurosurg 119:7–14. https://doi.org/10.3171/2013.3.JNS121492 CrossRefPubMed

20.

Krainik A, Lehericy S, Duffau H, Vlaicu M, Poupon F, Capelle L, Cornu P, Clemenceau S, Sahel M, Valery CA, Boch AL, Mangin JF, Bihan DL, Marsault C (2001) Role of the supplementary motor area in motor deficit following medial frontal lobe surgery. Neurology 57:871–878CrossRef

21.

Ulu MO, Tanriover N, Ozlen F, Sanus GZ, Tanriverdi T, Ozkara C, Uzan M (2008) Surgical treatment of lesions involving the supplementary motor area: clinical results of 12 patients. Turk Neurosurg 18:286–293PubMed

22.

Zentner J, Hufnagel A, Pechstein U, Wolf HK, Schramm J (1996) Functional results after resective procedures involving the supplementary motor area. J Neurosurg 85:542–549. https://doi.org/10.3171/jns.1996.85.4.0542 CrossRefPubMed

23.

Nakajima R, Kinoshita M, Yahata T, Nakada M (2019) Recovery time from supplementary motor area syndrome: relationship to postoperative day 7 paralysis and damage of the cingulum. J Neurosurg 1–10. https://doi.org/10.3171/2018.10.JNS182391

24.

Nelson L, Lapsiwala S, Haughton VM, Noyes J, Sadrzadeh AH, Moritz CH, Meyerand ME, Badie B (2002) Preoperative mapping of the supplementary motor area in patients harboring tumors in the medial frontal lobe. J Neurosurg 97:1108–1114. https://doi.org/10.3171/jns.2002.97.5.1108 CrossRefPubMed

25.

Baker CM, Burks JD, Briggs RG, Smitherman AD, Glenn CA, Conner AK, Wu DH, Sughrue ME (2018) The crossed frontal aslant tract: a possible pathway involved in the recovery of supplementary motor area syndrome. Brain Behav 8:e00926. https://doi.org/10.1002/brb3.926 CrossRefPubMedPubMedCentral

26.

Oda K, Yamaguchi F, Enomoto H, Higuchi T, Morita A (2018) Prediction of recovery from supplementary motor area syndrome after brain tumor surgery: preoperative diffusion tensor tractography analysis and postoperative neurological clinical course. Neurosurg Focus 44:E3. https://doi.org/10.3171/2017.12.FOCUS17564 CrossRefPubMed

27.

Abel TJ, Buckley RT, Morton RP, Gabikian P, Silbergeld DL (2015) Recurrent supplementary motor area syndrome following repeat brain tumor resection involving supplementary motor cortex. Neurosurgery 11(Suppl 3):447–455; discussion 456. https://doi.org/10.1227/NEU.0000000000000847 CrossRefPubMedPubMedCentral

28.

Rostomily RC, Berger MS, Ojemann GA, Lettich E (1991) Postoperative deficits and functional recovery following removal of tumors involving the dominant hemisphere supplementary motor area. J Neurosurg 75(1):62–8CrossRef

29.

Bleasel AF, Morris HH 3rd (1996) Supplementary sensorimotor area epilepsy in adults. Adv Neurol 70:271–84

30.

Bannur U, Rajshekhar V (2000) Post operative supplementary motor area syndrome: clinical features and outcome. Br J Neurosurg 14(3):204–10

31.

Fontaine D, Capelle L, Duffau H (2002) Somatotopy of the supplementary motor area: evidence from correlation of the extent of surgical resection with the clinical patterns of deficit. Neurosurgery 50(2):297–303PubMed

32.

Peraud A, Meschede M, Eisner W, Ilmberger J, Reulen HJ (2002) Surgical resection of grade II astrocytomas in the superior frontal gyrus. Neurosurgery 50(5):966–75PubMed

33.

Rosenberg K, Nossek E, Liebling R, Fried I, Shapira-Lichter I, Hendler T, Ram Z (2010) Prediction of neurological deficits and recovery after surgery in the supplementary motor area: a prospective study in 26 patients. J Neurosurg 113(6):1152–63CrossRef

34.

Ibe Y, Tosaka M, Horiguchi K, Sugawara K, Miyagishima T, Hirato M, Yoshimoto YBr (2016) Resection extent of the supplementary motor area and post-operative neurological deficits in glioma surgery. J Neurosurg 30(3):323–9CrossRef

35.

Vassal M, Charroud C, Deverdun J, Le Bars E, Molino F, Bonnetblanc F, Boyer A, Dutta A, Herbet G, Moritz-Gasser S, Bonafé A, Duffau H, de Champfleur NM (2017) Recovery of functional connectivity of the sensorimotor network after surgery for diffuse low-grade gliomas involving the supplementary motor area. J Neurosurg 126(4):1181–1190CrossRef

Titel: Postoperative isolated lower extremity supplementary motor area syndrome: case report and review of the literature
verfasst von: Nardin Samuel
Brian Hanak
Jerry Ku
Ali Moghaddamjou
Francois Mathieu
Mahendra Moharir
Michael D. Taylor
Publikationsdatum: 09.11.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Child's Nervous System / Ausgabe 1/2020
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-019-04362-2

Non-invasive assessment of ICP in children: advances in ultrasound-based techniques

Focus Session

The role of ICP overnight monitoring (ONM) in children with suspected craniostenosis

Focus Session

Management of mature pineal region teratomas in pediatric age group

Original Article

The relation of optic nerve sheath diameter (ONSD) and intracranial pressure (ICP) in pediatric neurosurgery practice - Part I: Correlations, age-dependency and cut-off values

Focus Session

Peripheral facial nerve palsy following ventriculoperitoneal shunting in an infant

Case Report

Atlantoaxial dislocation due to os odontoideum in patients with Down’s syndrome: literature review and case reports

Case-Based Update

Neu im Fachgebiet Chirurgie

Nur selten ernste Komplikationen bei endoskopischer Sinuschirurgie

19.03.2025
Rhinosinusitis
Nachrichten

Etwa 3% der Menschen mit einer endoskopischen Nasennebenhöhlenoperation entwickeln ausgeprägtes Nasenbluten. Andere Komplikationen, wie Verletzungen des Nervus opticus oder eine Meningitis, treten nur äußerst selten auf, legt eine Registeranalyse nahe.

Hochrisiko-Spinaliom am besten mit der Mohs-Chirurgie entfernen

18.03.2025
Plattenepithelkarzinom der Haut
Nachrichten

Die Mohs-Chirurgie ist zwar mit mehr Aufwand verbunden als die herkömmliche Exzision; für die Versorgung kutaner Hochrisiko-Plattenepithelkarzinome lohnt sich die zeitintensive Technik aber in jedem Fall. Laut einer aktuellen Studie sinkt im Vergleich das Sterberisiko.

Mechanische Herzklappe beschert jüngeren Betroffenen längeres Leben

17.03.2025
Herzklappenersatz
Nachrichten

Patienten und Patientinnen bevorzugen bioprothetische Herzklappen gegenüber mechanischen Klappenprothesen. Diese Wahl könnte sich zumindest für jüngere Patienten nachteilig auswirken: Ihnen bietet eine mechanische Klappe anscheinend einen Überlebensvorteil.

Darmpolyp weg – Peptid-Gel gegen Nachblutungen drauf?

17.03.2025
Darmpolypen
Nachrichten

Das Nachblutungsrisiko nach einer endoskopischen Mukosaresektion von flachen kolorektalen und duodenalen Adenomen war in der deutschen PURPLE-Studie mit einem hämostatischen Gel nicht kleiner als ohne Prophylaxe.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Postoperative isolated lower extremity supplementary motor area syndrome: case report and review of the literature

Abstract

Weitere Artikel der Ausgabe 1/2020

Non-invasive assessment of ICP in children: advances in ultrasound-based techniques

The role of ICP overnight monitoring (ONM) in children with suspected craniostenosis

Management of mature pineal region teratomas in pediatric age group

The relation of optic nerve sheath diameter (ONSD) and intracranial pressure (ICP) in pediatric neurosurgery practice - Part I: Correlations, age-dependency and cut-off values

Peripheral facial nerve palsy following ventriculoperitoneal shunting in an infant

Atlantoaxial dislocation due to os odontoideum in patients with Down’s syndrome: literature review and case reports

Neu im Fachgebiet Chirurgie

Nur selten ernste Komplikationen bei endoskopischer Sinuschirurgie

Hochrisiko-Spinaliom am besten mit der Mohs-Chirurgie entfernen

Mechanische Herzklappe beschert jüngeren Betroffenen längeres Leben

Darmpolyp weg – Peptid-Gel gegen Nachblutungen drauf?

Update Chirurgie

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten