Supplementary Motor Area Syndrome and Flexor Synergy of the Lower Extremities
In March 2008, a 48-year-old woman who developed left hemiparesis was diagnosed with a 2-cm-sized low grade glioma in the right superior frontal gyrus. She underwent tumor resection on June 24, 2008 () and was later transferred to the department of rehabilitation medicine.\nOn July 19, 2008, neurologic examination showed that the degree of spasticity was MAS grade I at hip, knee, and ankle joints. The power of her left upper extremities was fair grade, and her hip girdle, knee, and ankle powers were trace, zero, and zero grades, respectively. She was normal on sensory function tests. The deep tendon reflexes of her left knee and ankle were increased, and Babinski sign was positive.\nAfter receiving rehabilitation treatment for 2 weeks, her motor function was much improved. The power of her left upper extremity was good grade, her hip flexor power fair(+) grade, her extensor power poor grade, her knee flexor power fair(+) grade, her extensor power poor grade, her ankle dorsiflexor power trace grade, her plantar flexor power poor grade, and her lower extremity Fugl-Meyer score 17. Her gait function was much improved, and she was able to walk independently. Though her ankle dorsiflexor was still trace grade, she did not show foot-dragging during the swing phase. On August 2, 2008, a gait analysis was performed, which showed a decreased range of motion at ankle plantarflexion and dorsiflexion. But ankle dorsiflexion was sufficient not to show foot-dragging. Other findings were not significant ().