Dysexecutive Syndrome – Frontal Lobe Impairment

Dysexecutive Syndrome (DES) is considered in three broad categories – cognitive, behavioural and emotional.

Dysexecutive syndrome refers to a range or cluster of cognitive, behavioural and emotional outcomes, which frequently occur together following a brain injury. 

The term ‘dysexecutive syndrome’ is preferred over ‘frontal lobe syndrome’ because it emphasises the functional deficits rather than a location of the injury. The magnitude of these deficits varies from person to person, and not everyone struggles with the same things.

It is often the case that many people struggle to recognise their deficits and just one of the reasons for this is that for many people there is a part of the brain that still thinks it can do all the things it could before. Very often, people only notice their struggles when they are trying to do something.

The outcomes can include a range of thinking issues such as having problems with maintaining attention, impaired memory, with perception – recognising things and what is going on the environment – and difficulties with language and loss of insight.

They also include emotional and behavioural changes that frequently occur following brain trauma such as, a lowered tolerance of frustration, rapid mood swings, disinhibition and anxiety.

If we think about it, we rarely think about, or even notice our executive skills – most of us take these functions for granted. It is usually only following neurological damage that people begin to notice things like, the inability to think ahead, to be able to ‘visualise’ and see the bigger picture, process information and thoughts, problem solve and reach conclusions.

All of these outcomes are very disabling, and just trying to break through these can be incredibly frustrating. We will talk about all of these things and many more in much more detail on the attributed pages.

Because these cognitive, behavioural, and emotional outcomes often happen together, there can be a lot of confusion about the overlap. Try to resist worrying too much about the exact route of a problem, and think instead in terms of questions. For example:-

  • Cognitive– Am I having trouble working out how to do something? Do people try and show me how to do things?
  • Behavioural– Are people telling me that I have changed and don’t behave in the same ways; or, am I aware after consideration that the way I approach things is different?
  • Emotional– Are people telling me that I am more sensitive, more easily upset, or that I react in a different way to how I would have done before? Do I feel out-of-control?

We address each of these areas in lots of detail explaining how it may feel to the injured person, and also the everyday observations made by families and friends. Most importantly, we cover what is ‘really’ going on to increase understanding.

If you want to know more about the technicalities, there is an excellent description of Dysexecutive Syndrome on Wikipedia. The article is straightforward and explains why the terminology changed from ‘Frontal Lobe Syndrome.’ The latter diagnostic descriptive refers to an area of the brain, rather than the symptoms and outcomes. Often these outcomes do not manifest just from the damage to the frontal lobes, and so the diagnostic descriptive was changed to Dysexecutive Syndrome.