Postoperative isolated lower extremity supplementary motor area syndrome: case report and review of the literature

  • Nardin Samuel
  • Brian Hanak
  • Jerry Ku
  • Ali Moghadammjou
  • Francois Mathieu
  • Mahendra Moharir
  • Michael D. TaylorEmail author
Case Report


The supplementary motor area (SMA) syndrome is characterized by transient weakness and akinesia contralateral to the side of the affected hemisphere. The underlying pathology of the syndrome is not fully understood but is thought to be related to lesions in the SMA, residing principally in the mesial superior frontal gyrus (Broadmann’s area 6c). Although the SMA syndrome a well-characterized clinical entity, we report herein, to our knowledge, the first case of isolated lower extremity SMA syndrome in the literature. This case highlights the importance of considering this rare clinical entity in the context of new or worsening postoperative neurologic deficits. Moreover, early studies did not support somatotopic organization of the SMA as in the primary motor cortex; emerging evidence suggests that delicate somatotopic representation may underlie distinct presentations like that reported in the present case.


Supplementary motor area SMA syndrome Postoperative deficit Pediatric 


Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest to declare.


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© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Neurosurgery, Department of SurgeryUniversity of TorontoTorontoCanada
  2. 2.Division of NeurosurgeryThe Hospital for Sick ChildrenTorontoCanada
  3. 3.Division of NeurologyThe Hospital for Sick ChildrenTorontoCanada
  4. 4.The Hospital for Sick ChildrenUniveristy of Toronto, Peter Gilgan Centre for Research and Learning (PGCRL)TorontoCanada

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