The environmental dependency syndrome, imitation behaviour and utilisation behaviour as presenting symptoms of bilateral frontal lobe infarction due to moyamoya disease.

The environmental dependency syndrome, imitation behaviour and utilisation behaviour may be the earliest and most subtle signs of bifrontal lobe dysfunction. A case is described in which these signs constituted the predominant deficits. The lesions responsible were bifrontal infarcts caused by moyamoya disease. The patient made an excellent recovery.