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Letter   |    
Anatomic Basis of Klüver-Bucy Syndrome
Brendan T. Carroll, M.D.; Harold W. Goforth, M.D.; Lisa A. Carroll, B.S.N, R.N.
The Journal of Neuropsychiatry and Clinical Neurosciences 1999;11:116-116.
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Klüver-Bucy Syndrome

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.5

We have reported 2 cases exhibiting the clinical features of KBS (B.T. Carroll et al., unpublished).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.6

We 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.

Klüver H, Bucy PC: Preliminary analysis of functions of the temporal lobes in monkeys. Arch Neurol Psychiatry  1939; 42:979—1000
 
Lilly R, Cummings JL, Benson DF, et al: The human Klüver-Bucy syndrome. Neurology  1983; 33:1141—1145
[PubMed]
 
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—358
[PubMed]
 
Gloor P: The Temporal Lobe and Limbic System. New York, Oxford University Press, 1997
 
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—397
[CrossRef] | [PubMed]
 
Kalivas PW, Barnes CD, eds. Limbic Motor Circuits and Neuropsychiatry. Boca Raton, FL, CRC Press, 1993
 
Hooshmand H, Sepdham T, Vries JK: Klüver-Bucy syndrome: successful treatment with carbamazepine (letter). JAMA  1974; 229:1782
[CrossRef] | [PubMed]
 
Stewart JT: Carbamazepine treatment of a patient with Klüver-Bucy syndrome. J Clin Psychiatry  1985; 46:496—497
[PubMed]
 
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References

Klüver H, Bucy PC: Preliminary analysis of functions of the temporal lobes in monkeys. Arch Neurol Psychiatry  1939; 42:979—1000
 
Lilly R, Cummings JL, Benson DF, et al: The human Klüver-Bucy syndrome. Neurology  1983; 33:1141—1145
[PubMed]
 
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—358
[PubMed]
 
Gloor P: The Temporal Lobe and Limbic System. New York, Oxford University Press, 1997
 
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—397
[CrossRef] | [PubMed]
 
Kalivas PW, Barnes CD, eds. Limbic Motor Circuits and Neuropsychiatry. Boca Raton, FL, CRC Press, 1993
 
Hooshmand H, Sepdham T, Vries JK: Klüver-Bucy syndrome: successful treatment with carbamazepine (letter). JAMA  1974; 229:1782
[CrossRef] | [PubMed]
 
Stewart JT: Carbamazepine treatment of a patient with Klüver-Bucy syndrome. J Clin Psychiatry  1985; 46:496—497
[PubMed]
 
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