Frontal lobe signs

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Frontal lobe signs are focal neurological signs that may help to indicate a frontal lobe lesion.

monoparesis or hemiparesis depending on extent of damage

focal motor seizures - either spreading with a Jacksonian march or rapid generalisation to give tonic-clonic seizures; status epilepticus is not an uncommon presentation of frontal lobe tumours

expressive/Broca's dysphasia if in dominant hemisphere

paralysis of head and eye movements to opposite side - head and eyes deviated towards side of lesion

change in personality - inappropriate jocularity, loss of initiative and concern, akinetic mutism, disinhibition, general retardation

primitive reflexes - grasp, pout, palmar-mental, brisk jaw-jerk; changes in deep tendon reflexes contralaterally

unsteadiness in walking; rarely, gait apraxia

resistance to passive movements of the limbs - paratonia

incontinence of urine or faeces - cortical disinhibition

A patient with a frontal lobe space-occupying lesion on one side may cause optic atrophy in one eye, due to compression of the optic nerve, and papilloedema in the other eye, due to secondarily raised intracranial pressure - Foster Kennedy syndrome.

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Frontal lobe signs

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