Supplementary Motor Area Syndrome and Flexor Synergy of the Lower Extremities
In May 2008, a 60-year-old woman developed paraparesis and was diagnosed with falx meningioma (). On June 23, 2008, she underwent a tumor resection surgery and on July 1, 2008, she was transferred to the department of rehabilitation medicine for rehabilitation of paraparesis.\nOn July 1, 2008, neurologic examination showed grade I spasticity on the Modified Ashworth Scale (MAS) at hip, knee, and ankle joints; a hip flexor (right/left) power of fair grade/fair(-) grade, a hip extensor power of poor grade/trace grade, a knee extensor power of fair(-) grade/poor(+) grade, a knee flexor power of fair grade/fair(-) grade, an ankle dorsiflexor power of zero grade/zero grade, and an ankle plantar flexor power of zero grade/zero grade. On sensory function tests, she was bilaterally normal. Deep tendon reflexes of the knees and ankles were increased bilaterally and Babinski sign was positive bilaterally. Her lower extremity Fugl-Meyer score was 31/30. After receiving gait training for 2 weeks, she could walk with supervision. Although she did not drag her feet when walking, the motor power of her ankle dorsiflexor was still zero grade. On July 15, 2008, a gait analysis was performed and showed a normal pattern ().