ACUTE FRONTAL-LOBE SYNDROME AND DYSCONTROL ASSOCIATED WITH BILATERAL CAUDATE-NUCLEUS INFARCTIONS

Background. A 67-year-old man presented with acute onset of spatial an d temporal disorientation, memory loss and associated episodic dyscont rol. Investigations showed infarctions of both caudate nuclei. This pa tient presented a unique opportunity to study the relationship between the lesions, his behaviour, and neuropsychological testing. Method. S ingle case report. Investigations included interviews to determine cog nitive impairment, i.e. WAIS-R, MMSE, and neurological examination. Re sults. Extensive neuropsychological testing revealed severe impairment on tasks requiring planning, memory or abstract thought. These findin gs 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 mana gement.