PART 3 / CH 34
Bedside Frontal Lobe Evaluation
Roy Perlis
Observe
Emotional withdrawal
Depressive mood
Decreased initiative/motivation
Motor retardation
Blunted affect
Lability of mood
Disinhibition
Hostility/uncooperativeness
Excitement
Inattention
Poor planning
Inaccurate insight/self-appraisal
| Test | Look for |
|---|---|
| Serial 7 subtraction | stereotypes (100-93-83-73) |
| spell EARTH in reverse | stereotypes (T-H-R-E-A) |
| Months in reverse | July-June-May…June |
| Grasp reflex | presence of grasp |
| Go/No-Go “when I tap once, you tap twice; when I tap twice, don’t tap at all.” | inability to suppress impulse to tap, or copying examiner |
| Rhythm tapping | inability to mimic complex rhythm |
| Luria hand sequence (fist-chop-flat) “repeat these movements” | perseveration |
| Copying a pattern (peaks and squares) | perseveration (e.g., 2 peaks in a row) |
| Clock drawing | errors in planning (n.b. also tests parietal function) |
source: Ettlin T, Kischka U. Bedside Frontal Lobe Testing, in Neuropsychological Functions of the Frontal Lobes.