Experiments were conducted to study the contribution of prefrontal cortex to the generation and modulation of two varieties of P300 activity. Control subjects generated typical parietal maximal P300 responses to detected target stimuli. Unexpected, novel auditory stimuli presented to controls generated an earlier latency, fronto-centrally distributed P300 response. A similar earlier latency, fronto-central P300 is generated to unexpected, novel visual stimuli. The occurrence of this phenomenon in both the auditory and visual modalities suggests that it may reflect neural activity of a common CNS system involved in the orienting response. Subjects with unilateral prefrontal damage generated P300 complexes to target stimuli that did not differ from the control responses. Prefrontal damage, however, resulted in a specific defect in the P300 response to the unexpected novel stimulus. Prefrontal patients showed neither N200 enhancement nor the fronto-central P300 response to the novel stimulus that was found in control subjects. These findings indicate that prefrontal regions are critical for the organism's response to unexpected novel stimuli. Abnormalities in prefrontal control of sensory-limbic integration may be a critical element in the decreased P300 to novel stimuli found in these unilateral prefrontal lesioned patients. It is suggested that major features of the human frontal lobe syndrome may be explained by a physiological inability to control attention and orientation systems after prefrontal damage.