A young female patient with long history of sinusitis presented with frequent fever along with personality changes and headache of recent origin. The fundus examination revealed papilledema. The most likely diagnosis is: (AIIMS Nov 09)
|A||Frontal lobe abscess|
|D||Frontal bone osteomyelitis|
Frontal lobe abscess
Frontal lobe lesion
A. Foster Kennedy syndrome Q
Features: Ipsilateral optic atrophy and contralateral papilledema
B. A tumor of the frontal lobe is likely to damage the pre-frontal network. This presents as two relatively distinct syndromes.
i. Frontal disinhibition syndrome
a. Socially disinhibited and shows severe impairment of judgment, insight and foresight.
b. Antisocial behaviour is a characteristic feature of frontal disinhibition syndrome produced from frontal lobe damage
ii. Frontal abulic syndrome
a. Loss of initiative, creativity and curiosity
b. Pervasive emotional apathy and blandness
c. Akinetic mutism
C. Urinary incontinence can occur in lesion of paracentral lobule area of frontal lobe.
D. Frontal release signs – Grasp reflex, palmomental response, rooting reflex.
Extra Edge: Urinary incontinence is a feature of frontal lobe lesion.
Extra Edge: Akinetic mutism is a term describing patients tending neither to move (akinesia) nor speak (mutism). It is the result of severe frontal lobe injury in which the pattern of inhibitory control is one of increasing passivity and gradually decreasing speech and motion.