Ann Rehabil Med.  2013 Oct;37(5):735-739. 10.5535/arm.2013.37.5.735.

Supplementary Motor Area Syndrome and Flexor Synergy of the Lower Extremities

• Ryu JS
• Chun MH
• You DS

• KMID: 2266595
• DOI: http://doi.org/10.5535/arm.2013.37.5.735

Abstract

Clinical presentation of supplementary motor area (SMA) syndrome includes complete akinesia of the contralateral side of the body and mutism, with secondary recovery of neurologic deficit. Multi-joint coordination is frequently impaired following the development of a brain lesion and is generally restricted by abnormal patterns of muscle activation within the hemiparetic limb, clinically termed muscle synergies. However, no work to date has confirmed this observation with the aid of objective methods, such as gait analysis, and the development of reflex pattern has not been suggested as a possible cause. We describe two unusual cases of flexor synergy after tumor resection of SMA lesions.

Keyword

Motor cortex; Synergy; Gait; Brain neoplasms

MeSH Terms

Brain
Brain Neoplasms
Extremities
Gait
Lower Extremity*
Motor Cortex
Muscles
Mutism
Neurologic Manifestations
Reflex

Figure

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  Fig. 1 Enhanced brain magnetic resonance imaging of patient (case 1): (A) coronal view and (B) sagittal view.

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  Fig. 2 Gait analysis of patient 1 (a solid line, right side; a dotted line, left side). Pos, posterior; Ant, anterior; Ext, extention; Flx, flexion; Pla, planta flexion; Dor, dorsiflexion.

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  Fig. 3 T2-weighted brain magnetic resonance imaging of patient 2: (A) coronal view and (B) sagittal view.

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  Fig. 4 Gait analysis of patient 2 (a solid line, right side; a dotted line, left side). Pos, posterior; Ant, anterior; Ext, extention; Flx, flexion; Pla, planta flexion; Dor, dorsiflexion.

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