Klüver-Bucy Syndrome

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Yes, it is very common in Alzheimer's disease. I have also seen pts with bvFTD, s/p HSV encephalitis, and TBI who have had it. Most psychiatrists probably don't deal with this regularly, but it definitely comes up in geriatrics, neuropsych, and C-L psychiatry. It can be pretty devastating in younger patients.
 
splik said:
Yes, it is very common in Alzheimer's disease. I have also seen pts with bvFTD, s/p HSV encephalitis, and TBI who have had it. Most psychiatrists probably don't deal with this regularly, but it definitely comes up in geriatrics, neuropsych, and C-L psychiatry. It can be pretty devastating in younger patients.
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How did those patients present?
 
I haven't seen it but have more knowledge about it than most psychiatrists cause 1-They taught about it in a neuro-endocrine course I took as a psychology major in college, and 2-I used to work with a psychiatrist who specialized in TBI.

Like a few other disorders that are rare I spent years on the lookout for this type of thing cause I didn't want to miss a zebra but still never saw it. Another example is Wilson's Disease induced psychosis. Haven't seen one yet despite looking for it.

There's no point about bragging about my knowledge cause anyone can look it up in an academic article and there's no real strong data on any treatment for it. The person I worked with was decades ago, so that data is likely outdated or moved only at a snail's pace forward. His recommendation is you pretty much try atypical antipsychotics or mood stabilizers hoping something works cause there's very little data.

I have seen, however anti-NMDA autoimmune disease to the point where the patient could not care for herself (correctly diagnosed and because the patient needed a corticosteroid I had them go to the ER and the ER doctor would discharge the patient immediately despite me presenting evidence it was anti-NMDA autoimmune disease. The patient had to be sent to the ER over 5x until the idiot ER doctor finally looked at the data and admitted her), and a few other rare zebras.
 
painballer27 said:
How did those patients present?
Click to expand...
Had an inpatient on geri psych who had severe major neurocog with MRI showing atrophy everywhere and really bad in temporal lobes - unsure what the etiology was (FTD, vascular, alz, etoh?). He presented with pretty striking “hyper metamorphosis” eg would very randomly shift attention- pick up objects, look at them, and put them down, then walk away and come back, etc. Staff knew the most reliable way to redirect him was with foods- graham crackers would often take precedence over whatever else he was doing. And he asked about food constantly (hyperphagia). He also put a playing card in his mouth one time (hyperorality?). To the extent that he had behavioral disturbances they were always just sort of this child-like innocence of touching everything, wandering and being difficult to redirect.
So to me it seemed like he checked a lot of kluver bucy boxes, and/or chronic delirium (he was in the hospital for months like this). The thing about kluver bucy - while I thought it was a very interesting and cogent explanation for his behavior, it doesn’t really tell you anything besides that, does it? I.e. it’s a cool diagnosis that doesn’t change management.
 
He was recently caught with his pants down
 
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