Medial+Frontal+Lobe+Syndrome

In the medial frontal lobe syndrome apathy is the major characteristic. Anterior cingulate gyri, broadman's areas 24,32,33 are implicated in this syndrome

Affected individuals show: -Limited spontaneous movement and gesture -Limited speech -Akinetic mutism may appear - complete absence of motor activity and speech -Transcortical motor aphasia (Left SMA) -Lower extremity paresis and gait disturbance can be seen if damage extends to high precentral gyrus -Sphincteric disturbance (frontal lobe incontinence) common with bilateral medial damage. Individual tends to be indifferent to it -Loss of spontaneity and initiative - speculation with correlations to "free will"

Abulia is a term referring to more severe types of apathy

Differential Dx: Akinetic mutism can also follow bilateral damage to the midbrain and diencephalon