Sunday, June 17, 2018

Dozy Neuropsychologist Thinking Out Loud

The violin-maker's cat, over-exposed


We were talking about Trompe this morning, and I remarked idly that his cluster of behaviors rather resembles Frontal Lobe Syndrome. Then I started thinking about it, checked in my books, and finally saw the following online:

Characteristic features are:
  1. Decreased lack of spontaneous activity - the patient feels no desire to do anything and is unable to plan activities, but may have periods of restlessness.
  2. Loss of attention - the patient displays a lack of interest and is easily distracted.
  3. Memory is normal but the patient cannot be bothered to remember.
  4. Loss of abstract thought - eg, cannot understand proverbs.
  5. Perseveration - a tendency to continue with one form of behavior when a situation requires it to change.
  6. Change of affect - depending on the nature of the damage to the brain, the patient either becomes apathetic and 'flat' or becomes over-exuberant and childish or uninhibited with possibly inappropriate sexual behavior.
  7. The mini mental status protocol [the one used recently on him] does not measure frontal lobe damage properly. Other tasks where this impairment might show up are:  inability to maintain a sequence (messes up the order of elements); inability to follow instructions ["Do Not Congratulate" "Do not look at the sun"]; paucity of vocabulary ["I have the best words"]; inability to orient oneself in space [e.g., trouble learning the layout of a new place, such as, oh, the East Wing], inability to inhibit undesired actions [tearing up documents after being told repeatedly that they must be saved intact]. And there's more, isn't there.

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