• Vol. 40 No. 7, 336–337
  • 15 July 2011

Frontal Lobe Syndrome due to “A Bunch of Grapes”



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A 36-year-old female office clerk was admitted with a 6-week history of headache, abnormal behaviour (poor work performance, deteriorating table manners, and lack of social inhibition and frequent repetition of words or phrases) as well as unsteady gait. She also had episodes of urinary incontinence. On examination, she was found to be confused and disoriented. She had positive primitive reflexes (grasp, rooting and palmo-mental reflex) as well as upper motor neuron type of paraparesis. Routine laboratory investigations were unremarkable and her chest x-ray was normal. MRI brain showed multiple contrast enhancing lesions like “a bunch of grapes” related to the falx cerebri with significant surrounding vasogenic edema (Fig. 1).

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