A frontal lobe neoplasm may present with which of the following symptoms?

• A. Syncope
• B. Aphasia
• C. Bilateral hearing loss
• D. Disinhibition syndrome

Answer: (D)

Frontal lobe tumors commonly disrupt the brain’s ability to regulate behavior and impulse control. The orbitofrontal and ventromedial circuits play a key role in inhibiting socially inappropriate actions and making prudent judgments. When a neoplasm affects these areas, patients often show disinhibition: impulsivity, mood and personality changes, and unrestrained or socially inappropriate behavior. This behavioral change is a classic presentation of frontal lobe pathology.

Syncope isn’t a direct result of a brain tumor and reflects transient loss of consciousness from systemic or cardiac issues (or sometimes seizures, but not the focal inhibition problems characteristic of frontal involvement). Bilateral hearing loss points to problems in the auditory pathways (often brainstem or bilateral temporal regions) rather than the frontal lobes. Aphasia can occur with frontal lesions affecting language areas in the dominant hemisphere (Broca’s area), but the hallmark symptom most associated with frontal lobe tumors is disinhibition due to impaired executive control and reward/punishment processing.