An understanding of neuroanatomy is important to success as a neurologist and equally as important for success on the RITE and board exams. In this chapter, you will review key anatomic structures and their functions! We recommend that you review our “Cortex and Connections” chapter prior to reviewing the material outlined below.
Author: Brian Hanrahan MD, James Eaton MD, Steven Gangloff MD
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Frontal Lobe Syndromes
Orbitofrontal Syndrome
- Anatomical Function: The orbitofrontal area is involved with voluntary action, decision making, and socially appropriate behavior.
- Exam: Socially inappropriate behavior including Witzelsucht (joking addiction), disinhibition, echopraxia, and utilization behavior (reaching out and using objects in the environment in an automatic manner i.e. reflexively picking up a phone and bringing it to your ear).
Dorsolateral Frontal/Convexity Syndrome
- Anatomical Function: Involved with executive functions, working memory, and selective attention.
- Exam: Poor attention, motor programming, and immediate recall.
- The Wisconsin Card Sorting Test is a good test to evaluate for dorsolateral abnormalities.
Mesial Frontal Cortex Syndrome
- Also called the medial frontal cortex or anterior cingulate circuit syndrome.
- Anatomical Function: The mesial frontal cortex mediates motivated behavior, such as initiation of movement or speech.
- Exam: Amotivation, apathy, and akinesis. Akinetic mutism can be seen in bilateral lesions.
- Patients can be incontinent and may only eat or drink when fed.
- Treatment: Methylphenidate.
- Lesion: Posterior inferior frontal gyrus.
- See our language disorders chapter for more information.
Broca’s Aphasia
- Lesion: Posterior inferior frontal gyrus.
- See our language disorders chapter for more information.
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Brian Hanrahan, MD & Steven Gangloff, MD
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