Frontal lobe lesions

The frontal lobes are the seat of the higher mental functions, particularly the carrying out of complex mental operations, the 'executive functions'. Personality change is often the first sign of a frontal lobe lesion. Behaviour becomes disin-hibited, tactless, or ill-judged; mood is inappropriately euphoric; drive and concentration are diminished, although there is no formal intellectual impairment; and insight is lacking.

Neurological signs include a grasp reflex, anosmia, optic atrophy, and incontinence. If the lesion involves the motor cortex, there may be epileptic fits or contralateral spastic paresis.

Broca's area, in the inferior frontal lobe, is involved in language production; lesions here result in expressive dysphasia but relatively unimpaired comprehension.

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