Two cases of SMA syndrome after neurosurgical injury to the frontal aslant tract

Supplementary motor area (SMA) syndrome is characterised by transient disturbance in volitional movement and speech production which classically occurs after injury to the medial premotor area. We present two cases of SMA syndrome following isolated surgical injury to the frontal aslant tract (FAT) with the SMA intact. The first case occurred after resection of a left frontal operculum tumour. The second case occurred after a transcortical approach to a ventricular neurocytoma. The clinical picture and fMRI activation patterns during recovery were typical for SMA syndrome and support the theory that the FAT is a critical bundle in the SMA complex function.

Automated summary

Supplementary motor area (SMA) syndrome is a temporary disturbance in voluntary movement and speech production that occurs after injury to the medial premotor area. We describe two cases of SMA syndrome following surgical injury to the frontal aslant tract (FAT) with intact SMA. The clinical presentation and fMRI activation patterns during recovery were consistent with SMA syndrome, supporting the theory that FAT is a critical bundle in SMA complex function.