We present a case with frontal lobe
symptoms and Klüver-Bucy-like syndrome following subarachnoid hemorrhage and
hydrocephaly. Klüver-Bucy syndrome is a rare neurobehavioral condition
characterized by placidity, visual agnosia, hypersexuality, hyperorality, and
hypermetamorphosis (the tendency to react to or to touch every visual stimulus).
The syndrome is usually associated with lesions of the amygdala or its pathways,
and it occurs after head trauma, anoxia-ischemic encephalopathy, herpes simplex
encephalitis, and Reye ’s syndrome. A 45-year–old right-handed female patient,
who developed hydrocephaly after meningitis due to bilateral middle cerebral
artery aneurysm surgery presented to our psychiatry clinic with various
behavioral and emotional changes. In her psychiatric examination, increased and
disinhibited speech, perseveration, placidity, impaired go/no go task
performance, and hyperphagia were observed. The patient was treated with
risperidone 0.5 mg/day. Magnetic resonance imaging (MRI) of the brain showed
encephalomalacic-gliotic changes in the anterior superior medial temporal lobe
(including bilateral amygdala), hydrocephalus, bilateral abnormal signal
intensity in the white matter of the frontal region, and bilateral infarction in
the centrum semiovale. Symptoms, such as placidity (loss of anger and fear) and
altered dietary habits are some of the clinical features of Klüver-Bucy
syndrome, whereas disinhibition and perseveration are associated with prefrontal
cortex dysfunction.