Anatomic Basis of Klüver-Bucy Syndrome

Abstract

Back to table of contents Previous article Next article LetterFull AccessAnatomic Basis of Klüver-Bucy SyndromeBrendan T. Carroll, M.D., , Harold W. Goforth, M.D., , and Lisa A. Carroll, B.S.N, R.N., Brendan T. CarrollSearch for more papers by this author, M.D., Veterans Affairs Medical Center, Chillicothe, OH, Harold W. GoforthSearch for more papers by this author, M.D., Northwestern University, Chicago, IL, and Lisa A. CarrollSearch for more papers by this author, B.S.N, R.N., The Ohio State University Neuropsychiatric Facility, Columbus, OHPublished Online:1 Feb 1999https://doi.org/10.1176/jnp.11.1.116AboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail SIR: Classic Klüver-Bucy syndrome (KBS) has been considered a direct consequence of bilateral anterior temporal horn damage resulting from disease or injury.1,2 Hayman et al.3 recently described a case with MRI evidence of bilateral damage to the basolateral amygdala. Unfortunately, no autopsy was reported.Currently, the clinician is required to document the clinical features of KBS (“psychic blindness,” hypersexuality, hyperorality, hypermetamorphosis, altered emotional behavior, and memory deficits) and to demonstrate the existence of a bilateral lesion in the anterior temporal horn or amygdala.2 Gloor4 has reported that lesions in the amygdala are not necessary for KBS in animals or humans. Brain imaging is frequently abnormal but not specific for lesions in these areas in cases of KBS.5We have reported 2 cases exhibiting the clinical features of KBS (B.T. Carroll et al., unpublished). These cases lacked brain imaging evidence of bilateral damage to either the amygdala or the anterior temporal areas. However, KBS may still be present in such instances because of disruption of the limbic circuitry at the site of the mediodorsal thalamic relay.6We applaud the efforts of Dr. Hayman and colleagues3 to further the understanding of the anatomic basis of KBS. We feel that the present approach may limit the study of KBS in that cases of KBS may be rejected for lack of the designated anatomic lesions.There is some evidence to indicate that some of the clinical features of KBS may respond to carbamazepine treatment.7,8 In our 2 cases, antipsychotics were associated with clinical improvement. Management of KBS remains a challenging area. Treatment response to cases of KBS that lack the designated anatomic lesions may help to elucidate functional understanding of KBS.References1 Klüver H, Bucy PC: Preliminary analysis of functions of the temporal lobes in monkeys. Arch Neurol Psychiatry 1939; 42:979–1000Crossref, Google Scholar2 Lilly R, Cummings JL, Benson DF, et al: The human Klüver-Bucy syndrome. Neurology 1983; 33:1141–1145Crossref, Medline, Google Scholar3 Hayman LA, Rexer JL, Pavol MA, et al: Klüver-Bucy syndrome after selective damage of the amygdala and its cortical connections. J Neuropsychiatry Clin Neurosci 1998; 10:354–358Link, Google Scholar4 Gloor P: The Temporal Lobe and Limbic System. New York, Oxford University Press, 1997Google Scholar5 Aichner F: Die Phenomenologie des nach Klüver und Bucy benannaten Syndroms beim Menshchen [Phenomenology of the Klüver-Bucy syndrome in man]. Fortschr Neurol Psychiatr 1984; 52:375–397Crossref, Medline, Google Scholar6 Kalivas PW, Barnes CD, eds. Limbic Motor Circuits and Neuropsychiatry. Boca Raton, FL, CRC Press, 1993Google Scholar7 Hooshmand H, Sepdham T, Vries JK: Klüver-Bucy syndrome: successful treatment with carbamazepine (letter). JAMA 1974; 229:1782Crossref, Medline, Google Scholar8 Stewart JT: Carbamazepine treatment of a patient with Klüver-Bucy syndrome. J Clin Psychiatry 1985; 46:496–497Medline, Google Scholar FiguresReferencesCited byDetailsCited ByJournal of Clinical Neuroscience, Vol. 58Catatonia and Klüver-Bucy Syndrome in a Patient With Acute Disseminated EncephalomyelitisJose Fernando Muñoz Zúñiga, M.D., Jesus Ramirez-Bermudez, M.D., José de Jesús Flores Rivera, M.D., Teresa Corona, M.D.29 April 2015 | The Journal of Neuropsychiatry and Clinical Neurosciences, Vol. 27, No. 2Introductory notes to the psychodynamics of a case of Klüver-Bucy syndrome16 July 2015 | Neuropsychoanalysis, Vol. 17, No. 1Pediatric Hematology and Oncology, Vol. 24, No. 2Sertraline for Klüver—Bucy syndrome in an adolescent16 April 2020 | European Psychiatry, Vol. 20, No. 4 Volume 11Issue 1 February 1999Pages 116-116 Metrics History Published online 1 February 1999 Published in print 1 February 1999