Frontal Lobe Syndromes Workup

  • Author: Alberto J Espay, MD; Chief Editor: Michael Hoffmann, MBBCh, MD, FCP(SA), FAAN, FAHA   more...
 
Updated: Apr 27, 2010
 

Laboratory Studies

  • Choice of blood tests depends on clinical setting.
  • In many cases, tests of thyroid function, B-12 level, and serology for syphilis are appropriate.
  • In other instances, testing for HIV or connective tissue disorders is indicated.
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Imaging Studies

  • CT scanning is adequate to diagnose acute bleeds and ventriculomegaly (hydrocephalus).
  • MRI is more sensitive and specific than CT for showing tumors, focal or diffuse atrophy, subdural hematomas, or vascular and microvascular pathology.
  • Many behavioral neurology specialists would obtain a deoxyglucose PET scan in patients with a clinical diagnosis of frontotemporal dementia. A pattern of decreased frontal lobe glucose utilization with preserved temporal-parietal glucose utilization would favor the diagnosis of a frontotemporal dementia. The opposite pattern is characteristic of Alzheimer disease.
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Other Tests

  • Neuropsychology: Many tests are described in Physical.
  • EEG may be exceptionally considered if evidence of subclinical seizure activity is suspected, particularly in rapidly progressive symptomatic cases.
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Procedures

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Contributor Information and Disclosures
Author

Alberto J Espay, MD  Assistant Professor, Department of Neurology, Gardner Family Center for Parkinson's Disease and Movement Disorders, Director of Clinical Research, University of Cincinnati

Alberto J Espay, MD is a member of the following medical societies: American Academy of Neurology and Movement Disorders Society

Disclosure: Boehringer-Ingelheim Consulting fee Board membership; Medtronic Grant/research funds Other; Novartis Honoraria Speaking and teaching; Solvay Consulting fee Board membership; NIH Grant/research funds KL2 Research Scholars mentored career development award

Specialty Editor Board

Joseph Quinn, MD  Assistant Professor, Department of Neurology, Portland VA Medical Center, Oregon Health Sciences University

Joseph Quinn, MD is a member of the following medical societies: American Academy of Neurology, Society for Neuroscience, and Society for Pediatric Radiology

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Richard J Caselli, MD  Professor, Department of Neurology, Mayo Medical School, Rochester, MN; Chair, Department of Neurology, Mayo Clinic of Scottsdale

Richard J Caselli, MD is a member of the following medical societies: American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, American Medical Association, American Neurological Association, and Sigma Xi

Disclosure: Nothing to disclose.

Chief Editor

Michael Hoffmann, MBBCh, MD, FCP(SA), FAAN, FAHA  Professor of Neurology, University of Central Florida College of Medicine; Director of Cognitive Neurology, Director of Stroke Program, James A Haley Veterans Affairs Hospital

Michael Hoffmann, MBBCh, MD, FCP(SA), FAAN, FAHA is a member of the following medical societies: American Academy of Neurology, American Headache Society, American Heart Association, and American Society of Neuroimaging

Disclosure: Nothing to disclose.

References

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Axial brain MRI of a patient with progressive tremorless parkinsonism and frontal-predominant dementia (Mini Mental State Examination = 23/30; Frontal Assessment Battery = 10/18; abnormal clock drawing task and additional constructional impairment) with moderate ideomotor apraxia. The MRI demonstrates predominantly frontal (A) and anterior temporal atrophy (B) suggestive of frontotemporal dementia.
 
 
 
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