Acute frontal lobe syndrome and dyscontrol associated with bilateral caudate nucleus infarctions.
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.


METHODS
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.
Petty
R G
RG
Maudsley Hospital, Denmark Hill, London.
Bonner
D
D
Mouratoglou
V
V
Silverman
M
M
D000368:Aged; D000374:Aggression / Q000502:physiology; D002421:Caudate Nucleus / Q000503:physiopathology*; D002544:Cerebral Infarction / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D004292:Dominance, Cerebral / Q000502:physiology*; D005625:Frontal Lobe / Q000503:physiopathology*; D006801:Humans; D008297:Male; D019965:Neurocognitive Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D009483:Neuropsychological Tests; D011889:Rage / Q000502:physiology; D014057:Tomography, X-Ray Computed; D014754:Violence / Q000523:psychology