The clinical features of a case with postmortem evidence of bilateral lesions of the cingulate gyri (area 24) were descr. The earliest stage is characterized by apathy, akinesia, mutism, urinary incontinence, integrity of deep tendon reflexes, normal muscle tone, open eyes, physiologic pupils, indifference to pain, and bilateral Babinski signs (stage of "akinetic mutism" of Nielsen), the later stage is characterized , by progressively-deepening stupor with eventual coma and death ("terminal stage" of Nielsen). It is felt that the symptomatology and clinical course are so characteristic as to constitute a syndrome[long dash]the syndrome of the anterior cingulate gyri. The suggestion is made that the disturbances of pulse, respiration and temp. regulation, noted in the present case, may be a reflection of a fundamental derangement in the cortical autonomic regulatory mechanisms heretofore established as being closely associated with the cingulate gyri (area 24).