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Point me in the right direction (follow-up)

F. Frank LeFever flefever at ix.netcom.com
Mon Apr 5 21:44:09 EST 1999

No, no, no!

Evidently James does not have first-hand experience with patients with
"frontal lobe" syndrome.  There is some evidence that survivors of mild
TBI with chronic complaints may have compromise of some aspects of
"frontal" functioning (prefrontal cortex and/or basal ganglia), i.e.
deficits in attention, working memory, etc., but this is far from the
impaired concept formation (dorsolateral frontal) or the disinhibition
(orbitofrontal) one sees with serious frontal injury.

His awareness of problems and distress over the impact on his life is
rather atypical of frontal lobe syndrome and very typical of 
postconcussion syndrome--which is a problem for professionals precisely
because of the usual lack of direct evidence of brain damage
(prefrontal or elsewhere).

In my earlier response to this query, I said something about my own 
approach to the problem, one which raises the possibility of altered
function without obvious structural damage.

F. Frank LeFever, Ph.D.
New York Neuropsychology Group

In <370953ab.42926056 at news.ox.ac.uk> james.teo at chch.ox.ac.uk (Grushnik)
>Sounds like something happened in your prefrontal cortex. Sounds
>suspiciously too classic though.... Why don't you check you the case
>of Phineas Gage, who had a rod rammed through his skull? 
>Susan Greenfield also mentions him in some of her popular neuroscience
>book, among the many other books others have written on the subject.
>Alternatively you could look up the part of the brain called the
>prefrontal cortex.
>On Sun, 04 Apr 1999 22:23:14 -0800, Matthew Deming
><mdeming at linfield.edu> wrote:
>>I was wondering if anyone could refer me to a website or research
>>dealt with the following:
>>In 1990 I was in a serious motor accident where I hit the side of my
>>face on the dashboard causing my jaw to fracture and leaving me
>>unconscious for approximately 10 - 15 minutes.  Accordingly to a
>>right after we hit the embankment I managed to unbuckle my seatbelt,
>>my feet on the dash, push myself over the seat into the backseat and
>>crawl out the back driver side window and resting on the side of the
>>road. Anyways, I was taken to an emergency room and had a
>>or MRI?) where the imaging indicated that I had a clot of some sort
>>between the skin and my skull in the area above my right eye.  
>>Before the accident I was a well adjusted person, doing well in
>>active in sports, very outgoing, and very technically oriented. 
>>after the accident my grades began to take a turn for the worse, I
>>feeling drowsy, lathargic, not able to concentrate as much, I no
>>am interested in sports, and am a very shy and introverted person.
>>My diethas never changed, I've always ate quite healthy, never
>>in things such as soda and chocolate.  Oh, before the accident I had
>>clear flawless complextion.  After the accident I developed a really
>>acne problem that is still with me somewhat today.  Acne "didn't run"
>>my family, I don't know if this is common or not.
>>Anyways I'd appreciate any help in figuring out if I have a problem
>>not.  If you could direct me to any web sites or other research that
>>would most definately be helpful.
>>Thank you.
>>Matt Deming

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