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Acute frontal lobe syndrome and dyscontrol associated with bilateral caudate nucleus infarctions
R G Petty1, D Bonner, V Mouratoglou
1Maudsley Hospital, Denmark Hill, London.
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.