Kluver-Bucy syndrome as a result of minor head trauma. (Letters to the Editor).

To the Editor: Salim et al's (1) classification of their patient with a minor head injury as a case of Kluver-Bucy syndrome is open to question. Admittedly, their patient exhibited emotional blunting, excessive eating, and hypersexual behavior, three of the six essential features of Kluver-Bucy syndrome outlined by Lilly et a1 (2) in their landmark study. Nevertheless, this patient's overeating is qualitatively different from the human Kluver-Bucy syndrome, which typically yields a visual agnosia with oral exploration of the environment and the attendant ingestion of inedibles. In addition, Salim et al's patient exhibited "outbursts of irritation." These irritable outbursts eventually metamorphose into "aggressive behavior," and this ultimately becomes a "key point" in identifying Kluver-Bucy syndrome, according to Salim et al's schema. These outbursts, although they do not preclude Kluver-Bucy syndrome, are certainly not a core feature of this disorder--the lack of rage and fear responses is characteristic. In fact, none of this patient's behaviors are necessarily specific to Kluver-Bucy syndrome. Irritability, hypersexual behavior, and overeating all could prudently be ascribed to a subradiographic frontal injury. (3, 4)

David A. Olson, MD

Atlanta, GA

References

(1.) Salim A, Kim KA, Kimbrell BJ, Petrone P, Roldan G, Asensio JA. Kluver-Bucy syndrome as a result of minor head trauma. South Med J 2002;95:929-931.

(2.) Lilly R, Cummings JL, Benson DF, Frankel M. The human Bucy-Bucy syndrome. Neurology 1983;33:1141-1145.

(3.) Joseph R. Neuropsychiatry, Neuropsychology, and Clinical Neuroscience: Emotion, Evolution. Cognition, Language, Memory, Brain Damage, and Abnormal Behavior. Philadelphia, Lippincott williams & Wilkins, 1996, ed 2.

(4.) Takahashi N, Kawamura M. Oral tendency due to frontal lobe lesion. Neurology 2001;57:739-740.