Gourmand Syndrome: Difference between revisions
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[[File:Gourmand syndrome.jpg|400px|left|thumb| CT demonstrates acute hemorrhagic infarct in the distribution of the right [[middle cerebral artery]] involving the right internal capsule and basal ganglia (right side on image corresponds to right hemisphere) | [[File:Gourmand syndrome.jpg|400px|left|thumb| CT demonstrates acute hemorrhagic infarct in the distribution of the right [[middle cerebral artery]] involving the right internal capsule and basal ganglia (right side on image corresponds to right hemisphere) (Picture courtesy: [https://n.neurology.org/content/48/5/1185 Neurology])]] | ||
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'''Other Diagnostic Studies''' | '''Other Diagnostic Studies''' |
Revision as of 06:03, 20 July 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Joanna Ekabua, M.D. [2]
Synonyms and keywords:: Gourmand Syndrome
Overview
Gourmand syndrome is a benign, non-disabling eating disorder that arises as a result of a lesion to the right anterior cerebral hemisphere. Gourmand syndrome mainly involves the anterior cortico-limbic regions. Patients with gourmand syndrome are preoccupied with fine food reflecting a reduced cortical control of visceral impulses. Eating behavior that arises as a result of gourmand syndrome does not correlate with any known category of eating disorders.
Prominent cognitive symptoms associated with Gourmand syndrome include
- Visual-spatial dysfunctions.
- Impaired learning and recall of figures
- Recalling of a geometric figure when 90 degrees rotated
- Poor performance in figural fluency and verbal fluency. Twelve
- Left hemispatial neglect
Common risk factors in the development of Gourmand syndrome are
- Vascular
- Brain tumor
- Trauma
- Epilepsy
There is currently no treatment for gourmand syndrome.
Historical Perspective
- There is limited information about the historical perspective of gourmand syndrome.
- Gourmand syndrome was first described in 1997[1]
- Gourmand syndrome is derived from the French word gourmand which means someone who heartily enjoys eating fine food and drink, or simply a food lover; the term “gourmet” is reserved for a food connoisseur. Although commonly not considered a pathology, gourmand eating may sometimes indicate focal brain damage.[1]
Classification
- There is no established system for the classification of gourmand syndrome but it has been grouped into 2 main groups[2]
- The fine dining habits and changes to taste.
- The obsessive component.
Pathophysiology
- The pathogenesis of Gourmand syndrome is characterized by a lesion to the right cerebral hemisphere with the involvement of the cortical areas, basal ganglia, or limbic structures.[1]
![](/images/3/3a/Bg.png)
- Lesions are found frontal and temporal lobes of the brain. [2]
![](/images/1/1c/F-t_lobes.jpg)
- Right middle cerebral artery hemorrhagic infarction, including lesion to the right internal capsule and basal ganglia[1]
- Prominent neurologic findings indicate focal right-sided damage. Left-sided hemisyndromes; most frequent were 9 sensory-motor and 6 motor. Left-sided visual field defects (5 hemianopsia, 4 quadrantanopias). Epileptic seizures were recorded in 10 patients (7 complex partial seizure of focal right temporal origin). Neurological status was normal in 12 patients with abnormal mental status.[1]
- Gourmand syndrome symptoms arises in an average of 8 months after brain trauma. [1]
Clinical Features
Differentiating Gourmand Syndrome From Other Diseases
- Gourmand syndrome must be differentiated from other diseases such as:
Epidemiology and Demographics
- There is no information on the prevalence of gourmand syndrome.
- 36 people had been diagnosed with gourmand syndrome as of 2001.[3]
Age
- Gourmand syndrome is more commonly observed among patients aged 15-77years old.[1]
Gender
- Gourmand syndrome affects men and women equally.
Race
- There is no racial predilection to gourmand syndrome
Risk Factors
Common risk factors in the development of Gourmand syndrome are[1][2]
- Vascular
- Brain tumor
- Glioma
- Meningioma
- Tuberculoma
- Trauma
- Concussion with haemorrhage
- Epilepsy
Natural History, Complications, and Prognosis
- Early clinical features include a new-found obsession with fine foods and wanting to eat, talk and write about fine foods.[1]
- Common complication of gourmand syndrome is obesity.[1][2]
- There is no established data on the prognosis of gourmand syndrome.
Diagnosis
Diagnostic Criteria
- The diagnosis of gourmand syndrome is made when there is a change in eating behavior post brain trauma.[1]
Symptoms
Symptoms of Gourmand syndrome may include the following:[1][3]
- Outgoing and eating-oriented behavior
- Aroused only by conversations about food; wanting talk and write about refined foods
- Desires for homemade meals become more precise and exotic
- More concerned by quality rather than quantity of food
- Weight gain
- Depression
- Compulsive episode
- Psyschotic episode
Physical Examination
- Patients with Gourmand syndrome usually appear normal.[1]
Image showing the basal ganglia and limbic system of the human brain. (Picture courtesy: Pinterest)
- Physical examination may be remarkable for:
- Severe left sensory-motor hemisyndrome
- Left hemispatial neglect
- Impaired figural memory and figural fluency
- Mild extinction of left visual and tactile stimuli
- Left-sided astereognosis
- Poor impulse control
- Hyperverbality
- Disinhibition
- Heightened aggression and drive
- Affective Lability
- Indifference.
Laboratory Findings
- There are no specific laboratory findings associated with gourmand syndrome
Imaging Findings
CT may demonstrate hemmoragic infarct in the distribution of the right middle cerebral artery, involving the
![](/images/6/6b/Gourmand_syndrome.jpg)
Other Diagnostic Studies
- There is no diagnostic study for gourmand syndrome.
Treatment
Medical Therapy
- There is no treatment for gourmand syndrome; the mainstay of therapy is supportive care.
Surgery
- There is no surgical treatment for gourmand syndrome.
Prevention
- There are no primary preventive measures available for gourmand syndrome.
References
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 Regard M, Landis T (1997). ""Gourmand syndrome": eating passion associated with right anterior lesions". Neurology. 48 (5): 1185–90. doi:10.1212/wnl.48.5.1185. PMID 9153440.
- ↑ 2.0 2.1 2.2 2.3 2.4 Kurian M, Schmitt-Mechelke T, Korff C, Delavelle J, Landis T, Seeck M (2008). ""Gourmand syndrome" in a child with pharmacoresistant epilepsy". Epilepsy Behav. 13 (2): 413–5. doi:10.1016/j.yebeh.2008.04.004. PMID 18502182.
- ↑ 3.0 3.1 Uher R, Treasure J (2005). "Brain lesions and eating disorders". J Neurol Neurosurg Psychiatry. 76 (6): 852–7. doi:10.1136/jnnp.2004.048819. PMC 1739667. PMID 15897510.
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