Frontal Lobe

Frontal Lobe

Question: I was reading up on frontal lobe damage. My son is 23, but all his life was challenging. A number of events, and some that I am not aware of, makes me wonder if he suffers from frontal lobe damage. at 18 he ended up in the hospital. His brain, they said, was disorganized, and he was forced for 3 years to take a shot of Invega, same as Risperdal. He has been bizarre and disconnected ever since from me and lost everything he has known.

At 21 he quit the shots, and moved to FL. He can't keep a job, so lives on the streets. He became addicted to drugs early on and it has gotten worse, however, his symptoms actually started at 16.

He did boxing, and one day he said he felt like he was talking in a tunnel, like water inside. and I noticed his hand shaking. but he did not let me get him help.

At age 1 he fell down stairs, head first, but he just had a big bump and seemed OK.

Another symptom is his mood disorder, depression, and lack of reasoning. He also has a delay in his speech.

My reason for writing you is I am searching for a cure, so he can live a good life. I think stem cells with your own bone marrow could fix frontal lobe damage, if that is his illness. I want nothing more than to try an help him, it bothers my soul to him suffer and he wants his life back too. I am broke now, but when ever I do come into some money, I look forward to helping him. Do you think stem cells could heal him and his brain?

Answer: I am sorry about your son and the struggles he has had in his life. As you probably know from the reading you have done on the frontal lobe, there are a lot of ways that this particular part of the brain can become damaged. I doubt falling down stairs would have resulted in the type of symptoms you are describing to me. Drugs can alter the way the brain functions and can cause brain damage in some cases and in many cases it is difficult to determine if a person becomes addicted to drugs because their brain is already not functioning properly and the drugs make the person feel better or if the drug addiction was the initial cause of the brain disruption. 

Unfortunately, there is not an easy fix when the brain is involved. Without a solid diagnosis of what is the cause of your son's symptoms, it is unlikely that stem cells will work. Stem cells do not even work in people that have very specific causes of brain injury. It is a costly, experimental treatment for which there is no guarantee that it will work. Insurance does not cover the procedure and it is usually around $20,000 for an injection of stem cells. Many times the studies want to do more than one injection. The other issues is that stem cells for brain injuries is still considered an experimental treatment so I am not sure where you could have this done.

In my non-medical opinion, I think your son should be evaluated by a neuropsychologist who could determine if his frontal lobe is functioning the way that it needs to. Perhaps an MRI scan could also be done to determine if there has been specific damage to the bran that we can visualize. You should know that we cannot always see the damage to the brain on scans (even though it may exist). Perhaps rehabilitation to work on areas of struggle for your son would also be an option. You described speech delays, so perhaps an evaluation with a speech-language pathologist would be helpful, too. 


Question: I had brain surgery to remove a complex mengioma, however there was also a large coagulated blood clot in the right frontal lobe which left some dead brain tissue in that area. Since then i have had little to no emotions, a loss of drive to do things (prior to surgery i was extremely driven and self motivated, had extreme passion for anything and everything i needed to accomplish) my question is, is there any way to get that back? Or at least some of it? Any exercises i can do?

Answer: I am sorry to hear about your mengioma. The frontal lobe, as you know and have experienced, is involved in attention, motivation, emotions, verbal expression, judgment, decision making and other executive functions. Frontal lobe functioning is hard to rehabilitate since it is like the following analogy: the CEO of a company is suddenly no longer working at the company but the rest of the company has to continue to work and meet the goals of the company. The frontal lobes have pathways to most of the other areas of the brain so rehabilitation needs to involved getting those pathways to "talk" to each other again and "take over" some of the functions that were once primarily the job of the frontal lobe. The types of exercises involve repetition of tasks. For instance, you mentioned that it is difficult for you to be motivated to do tasks that you need to do. Once strategy might be to create a list of basic tasks that you need to accomplish each day (write them down, no matter how simple they seem). Then give yourself a reward after completing an item on the list. Repeat the list each day until these tasks become automatic and there is no longer a need for motivation to get them done. I have also attached an article regarding goal management training which is a newer tool/training used to rehabilitate executive functioning.

You may want to seek out the advice of your neurologist or psychologist for how you might be able to rehabilitate your emotions. It sounds to me as if the main issue is initiation. The inability to initiate tasks and even to initiate emotions. There may be medications that can assist with the treatment of initiation, but this may not be a "magic bullet" that fixes it entirely.


Question: I am enquiring about rehab for my good friend who has a frontal lobe injury and has gotten himself in trouble time and time again with the police. They are quick to throw him in jail, but nobody is willing to help rehabilitate him or help him.. I am pleading for some help, and would really appreciate to talk to someone in regards with options to help him. He struggles with self control, depression, suicidal thoughts and verbal anger. Otherwise he is a lovely man, very sweet and genteel.. The hey authorities don't believe me and just think I'm a girl that doesn't know the real man. Is there anyway getting medical help to help them understand his condition will help him get the help he needs rather than jail time that seems to make his anxiety, depression and other symptoms worse??

Answer: I am sorry to hear about your friend's injury. Sometimes a person can be "court ordered" for rehabilitation instead of jail time, especially if their frontal lobe injury is documented and they have never had rehabilitation before. Do you know if your friend's attorney has tried this approach? You may run into the issue that jail is cheaper than rehabilitation, unfortunately. It sounds as if you have experienced a bit of this already in that people are quick to judge your friend and not try to figure out alternative explanations for his behavior. There may be some rehabilitation facilities in Austrialia -- I am just not sure. You may also want to try to reach out to brain injury support groups and see if there are some resources that you could utilize for your friend. 


Question: In 2002 I had a tree hit me in forehead. My skull was in pieces and my frontal lobe was bleeding. I did not know who my kids were, etc. I recovered to the point of just short term memory lose. My question is, and don't know if this is possible, but I can now figure out situations quick, whether mechanical of someone asking advice. I don't need to "sleep on it". I can Solve many problems almost instantly. I've made things with whatever was around. I've had people ask me to invent an item they had no clue about. Is this possible. Because something has changed in my thinking.

Answer: I am sorry to hear about your injury. The frontal lobe controls many things, such as short term memory, attention, verbal expression, judgment, problem solving and decision making. It is interesting that you report that you can now solve problems quicker than you could previously. This may be due to impulsivity, which just means that you often act before you think. In some situations this could be a good thing, but often times it can be problematic because people aren't really thinking through all possibilities before acting on the first thought that comes to them. 


Question: How is impact to the frontal lobe measured/determined? My 1 1/2 year old fell off a parked ford truck, face down. Her doctor said she seems fine.

Answer:  I am sorry to hear of your child's fall. Since he/she is young, the frontal lobes have not yet fully developed yet (that will not occur until around age 25 for boys and around puberty for girls), so it can be difficult to determine if an injury was sustained to that part of the brain or not. The frontal lobe controls things like problem solving, attention, motivation, memory, etc. That being said, you are his mother and you know your child better than anyone else and if you think your child is acting differently than you should seek out the opinion of a neurologist who has more specialized knowledge regarding the brain. 


Question: I had a frontal lobe injury in an accident 30 years ago. My personality changed dramatically after. It took me about a year to recover; I was in to coma for a few months. Reading about brain injuries, I identified myself as a Pseudopsycopathic in many ways. Can it be caused by the injury in the right side of my frontal lobe? Can it be worsening after 30 years maybe due to situations in my life that triggered a condition that I was in me already in a mild stage?

Answer: I am sorry to hear of your frontal lobe injury. I am not familiar with the term "pseudopsycopathic". I can tell you that the frontal lobe is responsible for things like attention, motivation, impulsivity, judgement, decision-making, sequencing and problem solving. Many times a person who has suffered a frontal lobe injury will have personality changes, identified by themselves and by their family members. Situations like stress, change in routine, medical issues, etc can make a frontal lobe injury more significant to the point where you notice your deficits more. As the brain ages, there are changes that occur as well that may be contributing. 


Question: My father is 67 years old.He has been exposed to a car accident at 10/1/2017 that lead to both frontal and subarachnoid injury.

This was 4 months ago, he recognized us from the first moment but he remained unconscious for 10 days then he started to wake up.

He had four convulsions seizures and the last one was at 25/1/2017

He is followed by a neurological doctor , but we face a painful problem.

He is disoriented for places and sometimes for time, we went to a psychiatry and she advised with the following drugs
Abilify 10 mg (half tab daily)
quitapex 25 mg once daily

He remained at the same state, he has a duplication in the placed i.e. we have a house and a book store and he insist that we have two of each of them.

The other drugs he took are :
Epanutin 100 mg (three time daily)
Andovimpamide 100 mg (twice daily)
Alpha lipoic acid 300 mg twice dailt
Ginkgo biloba 40 mg twice daily.

I need your help to treat this disorientation for places as he suffer alot from being not allowed to work or go out alone.
Answer: As you may know, the frontal lobe is responsible for attention, emotional control, verbal expression, judgement, problem solving, decision making, and other executive functions. Often times after a brain injury, a person will be disoriented to the place, time, person, etc. Medications such as the ones you listed are not always beneficial for every patient to increase awareness/orientation of their surroundings. Rehabilitation professionals try to help patients with their orientation by asking him/her the date, their name, where they are right now, their place of birth, etc several times during the day. It appears that your father is also on anticonvulsant medications (Epanutin and Andovimpamide) to control his seizures. These medications can make a person disoriented and have "foggy" thinking, as well as, feel sleepy.

I would suggest you mention these issues with disorientation and duplication of place and see if these are "side effects" of the medications he is taking. Make sure to tell the neurologists all of the medications your father is taking, including those that were prescribed by the psychiatrist and any non-prescription (a.k.a. over the counter) medications as there could be a medication interaction that is causing the issue or perhaps a lower dose of some of the medications would alleviate these issues.


Question: My son- at 4, suffered a front of the cranium injury at a nearby park. He was unconscious for 3 days in the ICU at Choc Mission Hospital in California.

Luckily, he woke up during the last hours of the third day.

No follow up was ever recommended.

Because we tended to his every whim thereafter, we thought we had created a child that no longer cared to listed. We started noticing he couldn't "switch gears" and that he often got "stuck emotionally ".

At this very second- my husband and I just finished a 3 hour discipline session with him. After much grace, and much explaining, and many 1-2-3 countdowns, time outs, room time, quite time, spankings on his bottom. I believe he simply is now worn out- and has now gone to sleep after my husband prayed with him. We are Christian.

This has been a daily occurrence post his accident.

My husband heard a show on talk radio about frontal lobe damage and we read up on it- and fear, this might be the case with him.

Finding a great Neuro Dr. & an MRI is next, I think- so I'm writing to you, to get your advice, input, help- guidance, anything really!!

Answer: It might be a good idea to have a pediatric neurologist see your son to ensure there are not other issues going on. Another thing to consider is that your son's frontal lobe was not completely developed and then he sustained his injury. So, it is important to essentially "act" as his frontal lobe, which most parents have to do periodically anyway with a child, but because your son has had this injury, it may be even more important. Here are a few tips to keep in mind.... try to monitor your son before he gets overwhelmed and acts out. Often times, we even see with adults who have had a brain injury that when they get overstimulated, over tired or stress, their behavior tends to worsen. Allow for breaks before he gets to this point. Most likely your son will not understand cognitively when you reason with him. There are some behavioral techniques that may be important to use. I have attached a card that may help provide tips in this area. 

** More information about the frontal lobes >>