Post-Operative Supplementary Motor Area Syndrome

Rationale: Surgical removal of the lesions involving the supplementary motor area, results in immediate motor and speech deficits, which in most cases are reversible.Aim: Extent of removal of the supplementary motor area influences the post-operative deficits.Patients and Methods: 12 cases are included in this study, representing lesions involving the supplementary motor area by intra-axial growth, and or extra-axial compression, operated by microneurosurgical excision, after evaluation by magnetic resonance imaging of the brain with contrast, before and after the operation to evaluate the SMA involvement, and its extent of removal.Results: 12 cases in age range (10-60) years old, presented by, 10 epilepsy, 2 hemiparesis, MRI brain revealed lesions in the SMA, pathology was, 2 oligoastrocytoma, 3 astroctoma grade 2, 2 anaplastic astrocytoma, 2 glioblastoma multiforme, 2 metastases, 1 parasagittal meningioma, 9 cases with complete excision, 3 incomplete excision, SMA removal was complete in 5 cases, incomplete in 7 cases, immediate post-operative hemiplegia with preservation of the muscle tone, complete recovery within the 1st month post-operatively.Conclusion: Proper diagnostic methods aiming to localizes the sensorimotor area can minimize the risk of deficit in the surgical treatment of SMA lesions. The results suggest a relationship between the incidence of SMA syndrome and the extent of SMA resection.