Dysexecutive syndrome is a neurological impairment of executive function, where patients have trouble with complex thinking and reasoning tasks. It is most commonly seen in people with brain injuries. Some mental health conditions and cognitive disabilities can also create signs of dysexecutive syndrome. Treatment focuses on therapy and coping skills for the patient, often with the goal of helping people retain independence as long as possible. Eventually, the symptoms may become severe enough to require a full time caregiver or aide.
This condition was once known as frontal lobe syndrome, although this diagnosis has become outdated, as researchers now know that it involves more areas of the brain. Patients with the syndrome can experience emotional, cognitive, and behavioral deficits which may grow worse over time. The rate of impairment can accelerate if patients do not receive appropriate treatment, re-injure themselves, or have progressive neurological diseases that damage the brain more over time.
Emotionally, dysexecutive syndrome can make it difficult for people to regulate their emotions. They can develop mood swings and extremes. Some may appear self centered or rude as a result of cognitive impairments associated with the condition, which can make people more blunt because they do not understand the emotions of others as readily. Stubbornness can also develop, a not uncommon issue with neurological conditions as patients attempt to retain control over their lives.
Cognitive symptoms of dysexecutive syndrome can include a cluster of problems, particularly with planning and reasoning. An activity like taking a daily shower might be beyond the patient, who cannot plan out the corresponding and necessary activities, from putting out a towel to turning the shower on. It can also be difficult to solve problems. Communication deficits can arise, where the patient has trouble speaking or writing, or fails to understand communication from others. These can contribute to feelings of stress and frustration.
Patients with this condition can develop behavioral problems. They may not follow requests or orders from the people around them, and can become abrasive or irritable. Some behavioral outbursts are related to feelings of helplessness or anger about losing communication and reasoning skills. As patients experience an escalating level of impairment, these issues can become serious; a recalcitrant but physically healthy adult could injure a caregiver, for example.
An examination known as the Behavioral Assessment of Dysexecutive Syndrome (BADS) can be used at the time of diagnosis to determine the number and severity of symptoms. This can establish a useful benchmark for future medical evaluations. If the patient appears to be growing rapidly worse, this can be a sign that different approaches to therapy and treatment may be necessary.
