Frontal Lobe Lesions

The frontal lobe includes the motor cortex (areas 4, 6, 8, 44), the prefrontal cortex (areas 9-12 and 45-47), and the cingulate gyrus (p. 144). It is responsible for the planning, monitoring, and performance of motor, cognitive, and emotional functions (executive functions). Frontal lobe syndromes may be due to either cortical or subcortical damage and thus cannot be reliably localized without neuroimaging. The typical syndromes listed here are useful for classification but do not imply a specific diagnosis or exact localization of the underlying lesion.

Lateralized syndromes. Left frontal lobe lesions, depending on their location and extent, can produce right hemiparesis or hemiplegia, transcortical motor aphasia and diminished verbal output (p. 126), buccofacial apraxia (p. 128), and/or depression or anxiety. Right frontal lobe lesions can produce left hemiparesis or hemiplegia, left hemineglect (p. 132), mania, and/or increased psychomotor activity.

Nonlateralized syndromes. Fronto-orbital lesions produce increased drive, memory impairment with confabulation, and disorientation. Disinhibition and impaired insight into one's own behavior may produce abnormal facetiousness (German Witzelsucht), abnormal social behavior (loss of distance, sexual impulsiveness), indifference, or carelessness.

Lesions of the cingulate gyrus and premotor cortex produce syndromes ranging from abulia (loss of drive) to akinetic mutism (p. 120) and generally characterized by apathy, loss of interest, inertia, loss of initiative, decreased sexual activity, loss of emotion, and loss of planning ability. Urinary and fecal incontinence occur because of the loss of (cortical) perception of the urge to urinate and defecate. Altered voiding frequency or sudden voiding is the result. These patients are usually impaired in their capacity for divided attention (the processing of new information and adaptation to altered requirements, i.e., flexibility) and for directed attention (selective attention to a particular thing or task). Their attention span is short, they are easily distracted, they have difficulty in the execution of motor sequences, and they tend to perseverate (to persist in a particular activity or thought). Increased distractibility and prolonged reaction times impair performance in the workplace and in everyday activities such as driving.

Lesions of pathways. Lesions in pathways connecting the frontal lobe to other cortical and subcortical areas (p. 24) can produce frontal lobe-type syndromes, as can other diseases including multisystem atrophy, Parkinson disease, Alzheimer disease, normal-pressure hydro-cephalus, and progressive supranuclear palsy. Lesions of the corpus callosum. See p. 24.

Progressive Supranuclear Palsy

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Responses

  • maura fiorentino
    Is a left frontal lobe lesion ms?
    7 years ago
  • tommi
    Can ms lesions be located in the left frontal lobe?
    6 years ago
  • kasey anderson
    What to expect from ms lesions on left frontal lobe?
    6 years ago
  • Iago
    How does ms effect right frontal lobe?
    3 years ago
  • Amethyst
    What causes brain lesions on frontal lobe?
    3 years ago
  • agamennone
    DOES MS AFFECT THE FRONTAL LOBE?
    3 years ago
  • Kaari
    What diseases are associated with left frontal lobe lesions?
    2 years ago
  • connie cummins
    Is a lesion in parietal lob ms typical?
    2 years ago
  • maik
    Is frontal lobe lesions dangerous to health?
    1 year ago
  • Agata
    Why front cortex lesion on CT with MS?
    1 year ago
  • James
    How does frontal lobes affect an multiple sclerosis patient?
    11 months ago
  • costanzo
    What does it mean to have multiple sclerosis lesions on frontal lobes?
    10 months ago
  • arlo
    What does the front left lobe of brain do MS?
    9 months ago
  • kathrin
    What is ms disease in the frontal lobe of the brian?
    8 months ago
  • MICHAEL
    Does mulitple sclerosis produce frontal lobe dimentia?
    5 months ago
  • joe
    What is demyelination in frontal lobes?
    5 months ago
  • timothy
    Does ms affect the right temporal lobe?
    4 months ago
  • Melilot Lothran
    Can ms lesion be on right frontal lobe white matter?
    4 months ago
  • gilberto
    What symptoms would a right frontal lope lesion cause?
    3 months ago
  • richard
    What causes brain lesions on the fronta cortex?
    3 months ago
  • Nils
    Can ms lesions form only on the frontal lobe?
    1 month ago
  • adelard
    What happens when ms attacks your left frontal & patietal areas?
    28 days ago
  • zemzem
    What is nonspecific tiny left frontal lobe white matter lesion?
    24 days ago
  • tina
    Do frontal lobe lesions meet mcdonald criteria 2019?
    15 days ago

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