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Behavioural Neurology
Volume 6, Issue 4, Pages 229-237
http://dx.doi.org/10.3233/BEN-1993-6410
Case Report

Neurobehavioural Changes in a Patient with Bilateral Lesions of the Globus Pallidus

R. Haaxma,1,6 T. W. Robbins,2 M. James,3 W. H. Brouwer,1 J. G. Colebatch,4,5 and C. D. Marsden4

1Department of Neurology, University Hospital Groningen, The Netherlands
2Department of Experimental Psychology, University of Cambridge, UK
3Department of Psychology, The National Hospital for Neurology and Neurosurgery, Queen Square, UK
4University Department of Neurology, The National Hospital for Neurology and Neurosurgery, Queen Square, UK
5MRC Cyclotron Unit, Hammersmith Hospital, London, UK
6Department of Neurology, University Hospital Groningen, Broerstraat 5, POB 72, 9700 AB Groningen, The Netherlands

Received 30 September 1993; Accepted 17 October 1993

Copyright © 1993 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

This study has characterized the long-term neurobehavioural changes in a woman who, following the intake of an unidentified substance, sustained subtotal bilateral lesions of the globus pallidus and small lesions at selective sites adjacent to it. Associated with these lesions was a significantly reduced blood flow in multiple frontal cortical regions, most prominently in area 10, the anterior cingulate and the supplementary motor cortex. Her cognitive deficits were generally consistent with those found in patients with frontal lobe dysfunction but some deficits, i.e. in visual memory and learning, were more compatible with temporal lobe dysfunction. Incapacitating personality or obsessive compulsive changes as reported by others with similar lesions were absent and she could live independently. The cognitive changes are consistent with the view that the globus pallidus has important functions in mediating how internal representations of stimulus input are converted into various forms of action, for example, in planning solutions to problems and in working memory.