<prompt> Gegenhalten paratonia indicates lesion inParietal lobe dominantTemporal lobe dominantFrontal lobe dominantParietal lobe non-dominant  <response>: Ans. c Frontal lobe Ref. Harrison 18thFig 370-9.PARATONIA: tone that varies irregularly in a manner that may seem related to a degree of relaxation, is present throughout the range of motion, affects flexors and extensors equally, usually results from lesion of bilateral frontal lobes or dominant frontal lobe.RIGIDITY: Tone, affects flexors and extensors equally; seen in extrapyramidal lesionsSPASTICITY: tone, affects mainly extensors and seen in pyramidal tract lesions.Signs and symptomsStructures involved Paralysis of opposite foot and leg A lesser degree of paresis of opposite arm Cortical sensory loss over toes, foot, and legMotor leg areaArm area of cortex or fibers descending to corona radiateSensory area for foot and leg Urinary incontinenceSensorimotor area in paracentral lobule Contralateral grasp reflex, sucking reflex, gegenhaiten paratonic rigidityMedial surface of the posterior frontal lobe; likely supplemental motor area Abulia akinetic mutism, slowness, delay, intermittent interruption, lack of spontaneity, whispering, reflex distraction to sights and soundsUncertain localization--probably cingulate gyrus and medial inferior portion of frontal, parietaland temporal lobes Impairment of gait and stance gait apraxiaFrontal cortex near leg motor area Dyspraxia of left limbs, tactile aphasia in left limbsCorpus callosumDeficitfeature of lesion of a particular area of brainLobesImportant regionsDeficit after lesionFrontalPrimary motor and premotorFrontal eye fieldsBroca speech areaContralatera spastic paresis region depends on area of homunculusEyes deviate to ipsilateral sideBroca aphasia expressive, nonfluent aphasia: patient can understand written and spoken language, but speech and writing are slow and effortful; patients are aware of their problem; often associated with contralateral facial and arm weaknessPrefrontal cortexFrontal lobe syndrome: symptoms can include poor judgement, difficulty concentrating and problem solving, apathy, inappropriate social behaviorParietalPrimary somatosensory cortexSuperior parietal lobuleInfrerior parietal lobuleContralateral hemihypesthesia region depends on area homunculus affectedContralateral asteroegnosis and sensory neglect, apraxiaGerstmann syndrome if dominant hemisphere: rightleft: confusion, dyscalculia and dysgraphia, finger agnosia, contralateral hemianopia or lower quadrantanopiaTemporalPrimary auditory cortexBilateral damage deafnessUnilateral leads to slight hearing lossWernicke areaWernicke aphasia receptive, fluent aphasia; patient cannot understand any form of language; speech is fast and fluent, but not comprehensibleHippocampusAmygdalaOlfactory bulb, tract, primary cortexMeyer loop visual radiationsBilateral lesions lead to inability to consolidate short-term to long-termKluver-Bucy syndrome: hyperphagia, hypersexuality, visual agnosia Ipsilateral anosmiaContralateral upper quadrantanopia pie in the skyOccipitalPrimary visual cortexBlindnessAlso Remember: Parietal lobe lesions Dominant lobe Non dominant lobe Multinodal complex motor activities affected Multinodal complex sensory disabilities Ideational Ideomotor AlexiaApraxia Visuospatial disordersHemiattention AnosognosiaDressing and constructionalApraxia Gerstamanns syndrome 