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Acute Frontal Lobe Syndrome and Dyscontrol Associated with Bilateral Caudate Nucleus Infarctions

Published online by Cambridge University Press:  02 January 2018

Richard G. Petty*
Affiliation:
The Maudsley Hospital, Denmark Hill, London SE5 8AZ
Deirdre Bonner
Affiliation:
The Maudsley Hospital, Denmark Hill, London SE5 8AZ
Vassilis Mouratoglou
Affiliation:
The Maudsley Hospital, Denmark Hill, London SE5 8AZ
Marisa Silverman
Affiliation:
The Maudsley Hospital, Denmark Hill, London SE5 8AZ
*
R. G. Petty, University of Pennsylvania, Department of Psychiatry, Brain Behavior Laboratory, 10th Floor, Gates Building, 3500 Spruce Street, Philadelphia, Pennsylvania 19104-4283, USA. Fax: 215 662 7903

Abstract

Background

A 67-year-old man presented with acute onset of spatial and temporal disorientation, memory loss and associated episodic dyscontrol. Investigations showed infarctions of both caudate nuclei. This patient presented a unique opportunity to study the relationship between the lesions, his behaviour, and neuropsychological testing.

Method

Single case report Investigations included interviews to determine cognitive impairment i.e. WAIS-R, MMSE, and neurological examination.

Results

Extensive neuropsychological testing revealed severe impairment on tasks requiring planning, memory or abstract thought. These findings are very similar to those seen in Huntington's disease.

Conclusions

A neurobiological hypothesis is proposed to account for his symptoms, and recent discoveries in the basic sciences used to inform his management.

Type
Papers
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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