Diagnosis and treatment of patients with "frontal lobe" syndromes

J Neuropsychiatry Clin Neurosci. 1994 Fall;6(4):388-98. doi: 10.1176/jnp.6.4.388.

Abstract

Nine case descriptions illustrate the three major prefrontal syndromes seen in clinical practice: disorganized type, disinhibited type, and apathetic type. A mixture of symptoms from each subtype is usually seen, but dysfunction in one prefrontal system often dominates. A careful history and examination are essential for accurate diagnosis. A complete history can rarely be elicited from the patient alone. Structural brain imaging, especially MRI, and neuropsychological testing are key to the diagnostic workup. EEG, video-EEG, and functional brain imaging can be valuable in the evaluation of possible partial complex seizures of frontal lobe origin and other atypical frontal lobe disorders. Effective treatment requires educating the patient and the family about the illness and modulating environmental factors that influence the patient's behavior. Judicious use of psychoactive medication may be helpful, but adverse effects are common.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Brain Damage, Chronic / diagnosis*
  • Brain Damage, Chronic / drug therapy
  • Brain Damage, Chronic / physiopathology
  • Brain Mapping
  • Combined Modality Therapy
  • Dementia / diagnosis
  • Dementia / drug therapy
  • Dementia / physiopathology
  • Diagnosis, Differential
  • Diagnostic Imaging
  • Epilepsy, Frontal Lobe / diagnosis
  • Epilepsy, Frontal Lobe / drug therapy
  • Epilepsy, Frontal Lobe / physiopathology
  • Female
  • Frontal Lobe / drug effects
  • Frontal Lobe / pathology
  • Frontal Lobe / physiopathology*
  • Humans
  • Male
  • Middle Aged
  • Neurocognitive Disorders / diagnosis*
  • Neurocognitive Disorders / drug therapy
  • Neurocognitive Disorders / physiopathology
  • Neuropsychological Tests
  • Psychotropic Drugs / adverse effects
  • Psychotropic Drugs / therapeutic use
  • Syndrome

Substances

  • Psychotropic Drugs