Persistent Klüver-Bucy syndrome after bilateral thalamic infarction.

Objective: To describe a patient who exhibited a partial Klüver-Bucy syndrome after small bilateral ischemic lesions in the thalami.

Background: Previously reported patients with Klüver-Bucy syndrome had very large, mostly bilateral lesions in the limbic system and could not provide sufficient information about its anatomo-functional correlate.

Method: Behavioral assessments and clinical examinations, including magnetic resonance imaging and positron emission tomography, were conducted.

Results: The patient was severely amnestic, distractible, hyperoral, and affectively dyscontrolled, and she behaved socially inappropriately. Magnetic resonance imaging showed bilateral infarctions in the territories of both thalamoperforating arteries, and positron emission tomography revealed bilaterally decreased fluorodeoxyglucose uptake in the anterior parts of the ventral thalami and, to a lesser extent, in the fronto-temporal cortices.

Conclusions: This behavioral syndrome has not yet been reported with isolated diencephalic lesions, but it has been observed after bilateral temporal lobe lesions. The authors conjecture that this syndrome resulted from a disruption of the pathways connecting the dorsomedial thalami with the prefrontal cortices and with other limbic areas, systems essential for memory and the regulation of impulses and emotions.