RESUMEN
Klüver-Bucy syndrome (KBS) is a rare clinical presentation following traumatic brain injury (TBI). Symptoms include visual agnosia, placidity, hyperorality, sexual hyperactivity, changes in dietary behavior, and hypermetamorphosis. The purpose of this article was to identify and synthesize the available evidence from case reports and case series on the treatment profile of KBS among adolescents and adults after TBI. Four bibliographic databases (MEDLINE OVID, EMBASE, PsycINFO, and SCOPUS) were searched for relevant literature. No date or language restrictions were applied. All case reports containing original data on KBS following TBI among adolescents and adults were included. Articles were evaluated, and data were extracted according to predefined criteria. The literature search identified 24 case reports of KBS post-TBI published between 1968 and 2017. Most case subjects were male (70.1%), and the mean age at injury was 25.1 years (range, 13-67 years). Injury to one or both temporal lobes occurred in most cases. Inappropriate sexual hyperactivity was the most common KBS symptom, followed by a change in dietary behavior and hyperorality. Visual agnosia was the least reported. In 50% of cases, the patient fully recovered from KBS. One-half of all participants described pharmacological management; the most common medication prescribed was carbamazepine. Overall, there was a lack of data available on pharmacotherapy initiation and duration. The complex presentation of KBS presents challenges in terms of treatment options. Although overall individuals who were prescribed carbamazepine had positive outcomes, given the reliance on case reports, it is difficult to make a definitive recommendation to guide clinical practice.
Asunto(s)
Lesiones Traumáticas del Encéfalo/complicaciones , Carbamazepina/farmacología , Fármacos del Sistema Nervioso Central/farmacología , Síndrome de Kluver-Bucy , Adolescente , Adulto , Anciano , Femenino , Humanos , Síndrome de Kluver-Bucy/tratamiento farmacológico , Síndrome de Kluver-Bucy/etiología , Síndrome de Kluver-Bucy/fisiopatología , Masculino , Persona de Mediana Edad , Adulto JovenAsunto(s)
Trastorno Bipolar/diagnóstico , Bupropión/administración & dosificación , Demencia Frontotemporal/diagnóstico , Hidrocéfalo Normotenso , Síndrome de Kluver-Bucy , Antidepresivos de Segunda Generación/administración & dosificación , Diagnóstico Diferencial , Electroencefalografía/métodos , Femenino , Humanos , Hidrocéfalo Normotenso/diagnóstico , Hidrocéfalo Normotenso/tratamiento farmacológico , Hidrocéfalo Normotenso/psicología , Síndrome de Kluver-Bucy/diagnóstico , Síndrome de Kluver-Bucy/tratamiento farmacológico , Síndrome de Kluver-Bucy/psicología , Ventrículos Laterales/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Persona de Mediana Edad , Pruebas Neuropsicológicas , Tercer Ventrículo/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Resultado del TratamientoRESUMEN
We present the case of an 18-year-old women with Klüver-Bucy syndrome as sequela of Herpes simplex encephalitis. The symptomatology remitted partly under treatment with carbamazepine.
Asunto(s)
Encefalitis por Herpes Simple/diagnóstico , Herpesvirus Humano 1 , Síndrome de Kluver-Bucy/diagnóstico , Complicaciones Infecciosas del Embarazo/diagnóstico , Adolescente , Anticonvulsivantes/uso terapéutico , Edema Encefálico/diagnóstico , Edema Encefálico/tratamiento farmacológico , Carbamazepina/uso terapéutico , Encefalitis por Herpes Simple/tratamiento farmacológico , Femenino , Humanos , Síndrome de Kluver-Bucy/tratamiento farmacológico , Imagen por Resonancia Magnética , Embarazo , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Lóbulo Temporal/patologíaAsunto(s)
Anticonvulsivantes/uso terapéutico , Carbamazepina/uso terapéutico , Demencia Frontotemporal/tratamiento farmacológico , Síndrome de Kluver-Bucy/tratamiento farmacológico , Conducta Sexual/efectos de los fármacos , Anciano , Anticonvulsivantes/efectos adversos , Carbamazepina/efectos adversos , Relación Dosis-Respuesta a Droga , Demencia Frontotemporal/diagnóstico , Humanos , Síndrome de Kluver-Bucy/diagnóstico , MasculinoAsunto(s)
Anticonvulsivantes/uso terapéutico , Carbamazepina/uso terapéutico , Lóbulo Frontal/patología , Infarto de la Arteria Cerebral Anterior/complicaciones , Síndrome de Kluver-Bucy/fisiopatología , Adulto , Amígdala del Cerebelo/patología , Amígdala del Cerebelo/fisiopatología , Anticonvulsivantes/farmacología , Apatía , Conducta Apetitiva/efectos de los fármacos , Neoplasias Encefálicas/cirugía , Carbamazepina/farmacología , Craneotomía , Embolización Terapéutica , Resultado Fatal , Femenino , Lóbulo Frontal/fisiopatología , Humanos , Infarto de la Arteria Cerebral Anterior/diagnóstico , Infarto de la Arteria Cerebral Anterior/rehabilitación , Síndrome de Kluver-Bucy/tratamiento farmacológico , Síndrome de Kluver-Bucy/etiología , Imagen por Resonancia Magnética , Meningioma/cirugía , Vías Nerviosas/fisiopatología , Pruebas Neuropsicológicas , Embolia Pulmonar , Índice de Severidad de la EnfermedadRESUMEN
AIM: Klüver-Bucy syndrome was described in the fifties of the 20th century as a group of neuropsychological symptoms, such as visual agnosia, "oral" tendency, hypermetamorphosis, changes in behaviour, hyper-sexuality (homo-, hetero-, autosexuality) and changes in dietary habits (anorexia, bulimia) that may develop in humans after bilateral damage or dysfunction of the medial temporal lobes. The cause of Klüver-Bucy syndrome may be an injury, central nervous system infection, especially herpetic, Pick disease, temporal epilepsy and paraneoplastic encephalopathy. The condition is very rare in children; its occurrence in childhood was described in a few cases only. Symptom intensity and their manifestation depend on numerous diversified factors. METHODS: A comparative presentation of two clinical cases of Klüver-Bucy syndrome following severe head injuries accompanied by description of computed tomography scans. RESULTS: The diagnosis of the syndrome does not require the presence of all the axial symptoms. Both patients were treated with carbamazepine. Regression of neuropsychological symptoms took a different course in each child, despite their similar brain damage. CONCLUSIONS: Fully symptomatic Klüver-Bucy syndrome is very rare. The psychological status of patients with this disorder depends not only on the extent of the lesion, but also on pre-injury emotional and intellectual development and post-injury social stimulation.
Asunto(s)
Anticonvulsivantes/administración & dosificación , Carbamazepina/administración & dosificación , Traumatismos Craneocerebrales/complicaciones , Síndrome de Kluver-Bucy/diagnóstico por imagen , Síndrome de Kluver-Bucy/tratamiento farmacológico , Adolescente , Femenino , Lateralidad Funcional , Humanos , Síndrome de Kluver-Bucy/etiología , Masculino , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , UltrasonografíaRESUMEN
Described here is the case of a patient with liver cirrhosis who developed bilateral temporo-occipital lobe lesions on MRI and Klüver-Bucy syndrome following status epilepticus. Herpes encephalitis, paraneoplastic syndrome, Hashimoto's encephalopathy, reversible posterior leukoencephalopathy syndrome, mitochondrial encephalomyopathy, lactic acidosis, and strokelike episode syndrome were judged not to be involved on the basis of laboratory results. The possible cause of the temporo-occipital lesions on MRI in this patient was cortical damage related mainly to status epilepticus and partially to coexisting hepatic encephalopathy.
Asunto(s)
Encefalopatía Hepática/complicaciones , Síndrome de Kluver-Bucy/etiología , Lóbulo Occipital/fisiopatología , Estado Epiléptico/complicaciones , Lóbulo Temporal/fisiopatología , Corticoesteroides/uso terapéutico , Electroencefalografía , Femenino , Lateralidad Funcional , Encefalopatía Hepática/tratamiento farmacológico , Encefalopatía Hepática/patología , Humanos , Síndrome de Kluver-Bucy/tratamiento farmacológico , Síndrome de Kluver-Bucy/patología , Síndrome de Kluver-Bucy/fisiopatología , Cirrosis Hepática Alcohólica/complicaciones , Imagen por Resonancia Magnética , Persona de Mediana Edad , Lóbulo Occipital/patología , Estado Epiléptico/patología , Estado Epiléptico/fisiopatología , Lóbulo Temporal/patología , Resultado del TratamientoRESUMEN
Kluver-Bucy syndrome is a rare neurobehavioral condition characterized by visual agnosia, excessive oral tendency, hypermetamorphosis, placidity, altered sexual behaviors, and changes in dietary habits. The authors report a case of Kluver-Bucy syndrome in a 10-year-old boy with non-Hodgkin lymphoma after intratechal methotrexate administration. He was treated by risperidone without any sequels.
Asunto(s)
Síndrome de Kluver-Bucy/etiología , Linfoma no Hodgkin/complicaciones , Antimetabolitos Antineoplásicos/uso terapéutico , Niño , Diagnóstico Diferencial , Humanos , Inyecciones Espinales , Síndrome de Kluver-Bucy/tratamiento farmacológico , Linfoma no Hodgkin/tratamiento farmacológico , Masculino , Metotrexato/uso terapéuticoRESUMEN
Kluver-Bucy syndrome is a rare neurobehavioral condition characterized by visual agnosia, excessive oral tendencies, hypermetamorphosis, placidity, altered sexual behavior, and changes in dietary habits. This description of a 14-year-old boy presenting with complete Kluver-Bucy syndrome after Mycoplasma pneumoniae bronchitis is the first such case report. MRI revealed left temporal horn dilation and asymmetry of both temporal lobes. We hypothesize that the pathophysiology of our case is immune-mediated damage by M. pneumoniae resulting in vasculopathy.
Asunto(s)
Síndrome de Kluver-Bucy/etiología , Infecciones por Mycoplasma/complicaciones , Mycoplasma pneumoniae , Lóbulo Temporal/patología , Adolescente , Antibacterianos/uso terapéutico , Bronquitis/complicaciones , Bronquitis/microbiología , Humanos , Síndrome de Kluver-Bucy/diagnóstico , Síndrome de Kluver-Bucy/tratamiento farmacológico , Imagen por Resonancia Magnética , Masculino , Infecciones por Mycoplasma/tratamiento farmacológico , Roxitromicina/uso terapéuticoRESUMEN
A twelve-year-old female was admitted with history of high fever, recurrent vomiting and repeated convulsion for 2 days and altered consciousness for one day. Cranial CT scan showed intraparenchymal haemorrhage involving both temporal lobes and right basal ganglia region without mass effect. Serology was reactive against IGM HSV1. Injection acyclovir was started at a dose of 10 mg/kg 8 hourly intravenously. Patient regained consciousness on fourth day but speech was altered. Abnormal behavioural symptoms were noticed. EEG showed generalised spike and slow waves and sharp and slow wave discharge more in the temporal region. The patient was given clonidine and carbamazepine. She also received behavioural therapy and parental counselling. She was followed up for six months and maintaining well.