Abstract
We report on a patient (PG) with a severe behavioural disorder following massive bilateral prefrontal damage due to herpetic encephalitis. The lesion involves also the mesial and polar regions of the temporal lobes; the frontal dorso-lateral cortices were relatively spared. The patient's inattentiveness and alternating impulsive and apathetic behaviour led to her social alienation. The only self-motivated activities we observed were those initiated to satisfy her enhanced urge to eat and play games. She did not react to surprise stimuli that consistently elicit a reaction of surprise in healthy people. She also presented "adynamic aphasia" associated with anomia and episodic amnesia. A striking feature of the syndrome was the patient's consistent "utilization behaviour". Her motor behaviour was marked by constant akathisia. She performed surprisingly well on intelligence, "frontal", and visuo-spatial tests. This non-demented patient exhibited a clear dissociation between her relatively spared cognitive abilities and grossly impaired behaviour. In the discussion we explore the extent to which a defect of the supervisory control may be held responsible for the inconsistencies in the patient's coping skill performances.
Original language | English |
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Pages (from-to) | 27-51 |
Number of pages | 25 |
Journal | Cortex |
Volume | 30 |
Issue number | 1 |
Publication status | Published - Mar 1994 |
Keywords
- Adolescent
- Adult
- Attention
- Brain Damage, Chronic
- Brain Mapping
- Cognition Disorders
- Dominance, Cerebral
- Emotions
- Encephalitis
- Follow-Up Studies
- Frontal Lobe
- Herpes Simplex
- Humans
- Imitative Behavior
- Magnetic Resonance Imaging
- Mental Recall
- Motivation
- Neuropsychological Tests
- Social Behavior
- Stereotyped Behavior
- Verbal Behavior
- Journal Article
- Research Support, Non-U.S. Gov't