Klüver-Bucy syndrome describes a change in emotional expressive behavior. This is processed substantially in the limbic system. Damage leads to severe behavioral changes.
What is Klüver-Bucy syndrome?
Klüver-Bucy syndrome was named after its authors, Heinrich Klüver and Paul Bucy. Heinrich Klüver was a German-American neuroscientist and Paul Bucy was a U.S. neuropathologist. Together they studied behavioral changes in primates caused by lesions of the brain. In 1936, they succeeded in demonstrating an effect on emotional expressive behavior in an animal experiment. They conducted their lesion experiments in monkeys. They surgically removed both temporal lobes from them. As a result, the primates showed hyperoral as well as hypersexual behavior. The experimental animals lost the sense of their own need relevance. They put all objects into their mouths without being able to differentiate what consequences this might have. Their sexual behavior changed immensely. Mating behavior increased excessively. The animals were restless and showed hyperactivity. In humans, comparable symptoms are seen in Klüver-Bucy syndrome. It leads to failures in the processing of emotions of any kind. This has corresponding effects on emotional expressive behavior. Symptoms may also occur when brain areas related to the temporal lobes are affected. In particular, lesions of the amygdala alter emotional experience immensely.
Causes
Causes in Klüver-Bucy syndrome include lesions in the brain. In particular, it affects areas in close proximity to centers of emotional experience. Primarily, the limbic system deals with the occurrence of emotional events. In Klüver-Bucy syndrome there is a direct connection with the removal of the temporal lobes. These are located in close proximity to the limbic system. However, research found that lesions of adjacent brain regions also produced comparable results. Thus, damage to the amygdala also leads to changes in emotional processing. Fear and anxiety stimuli in particular are processed here and appropriate behavior is prepared. They serve as protection in dangerous situations. Lesions in the area of the temporal lobes and the limbic system can occur due to other various underlying diseases. Herpes simplex encephalitis and circulatory disorders in the brain should be mentioned here. Brain atrophy, or age-related tissue loss, is also considered a cause of the syndrome. In addition, Klüver-Bucy syndrome can result from craniocerebral trauma following accidents or surgery. Tumor diseases in the limbic system, hippocampus, or temporal lobes also cause the syndrome.
Symptoms, complaints, and signs
Symptoms of Klüver-Bucy syndrome notably include a change in social behavior. Excessive behavior may be observed. This ranges from excessive eating and drinking to aggressiveness when food and fluids are restricted. Hypersexual behavior could also be observed. The changes in emotional experience clinically demonstrate the absence of emotional empathy. Expression of emotions is severely altered or absent. There may be impairment or loss of sensations such as anxiety or fear. Sufferers of Klüver-Bucy syndrome show a tendency to engage in oral hyperactivity. This involves exploring objects in the environment with the mouth. Oral exploration behavior takes place very excessively. Existing emotions can quickly change from fear to aggression. The affected person is no longer able to adequately regulate his or her emotions. Affected persons show a hypermetamorphosis. They pay attention to significantly more stimuli than under normal circumstances. In some cases, visual agnosia occurs. This is a so-called soul blindness, in which visually perceived things can no longer be identified.
Diagnosis and course of the disease
The diagnosis is made after an extensive medical examination. This involves observations of behavior. In addition, magnetic resonance imaging is used to examine the individual brain regions for functionality.
Complications
Significant behavioral changes occur as a result of Klüver-Bucy syndrome.These changes usually have a very negative impact on the person’s life and social contacts. Exclusion or bullying and teasing may occur. The quality of life is significantly limited and reduced by Klüver-Bucy syndrome. In most cases, very aggressive behavior occurs. This occurs especially when the affected person is denied fluids or food. Furthermore, the patients not infrequently suffer from hyperactivity and are often unable to follow in school and suffer from concentration disorders. This can lead to considerable restrictions and discomfort in development. It is not uncommon for those affected to also suffer from anxiety or sweating. The environment is often examined with the tongue, which can lead to various infections and inflammations. In many cases, there is no treatment for Klüver-Bucy syndrome. The symptoms may be able to be limited and reduced with the help of various therapies. However, a complete cure is not possible in most cases. In many cases, the parents and relatives also suffer from psychological symptoms and therefore require psychological treatment.
When should one go to the doctor?
People who show severe behavioral abnormality in direct comparison to the norm need medical attention. An excessive demeanor, overreactions when interacting with people in a social setting, or highly sexual behavior are warning signs that indicate a mental disorder. A visit to the doctor is necessary as soon as the affected person shows hypersexuality and has other sexual partners several times a day or week. A doctor is needed if there is intense eating and aggressive behavior at the same time. In many cases, depending on their current condition, sufferers show a lack of insight into their illness. Therefore, relatives or other persons of trust are often obliged to gently point out inconsistencies to the affected person. A consultation with a physician is advisable beforehand so that the right steps can be taken for successful treatment. Oral fixation or oral hyperactivity indicate a present inconsistency. If adults examine surrounding objects in detail with their tongues or increasingly put various items in the environment in their mouths, a visit to the doctor is necessary. Sufferers perceive more stimuli than healthy people. Nevertheless, it is not possible for them to sufficiently process the sensory stimuli they take in. Therefore, a doctor should be consulted if the affected person cannot identify everyday objects as such.
Treatment and therapy
Treatment of Klüver-Bucy syndrome is very complex. To date, a complete cure has not been achieved. The lesions in each brain area are usually irreparable. To date, medical research has not been able to find a way to regrow or repair tissue damaged in the brain. Replacement by means of transplantation is also currently not possible. For this reason, individual therapy is carried out with the focus on alleviating existing symptoms. This depends on the type and extent of tissue damage. In everyday life, dietary habits are controlled. Medication is used to treat symptoms such as hypersexuality. If seizures occur, these are also treated with medication. Medication is also used for other psychotic symptoms. In most cases, people suffering from Klüver-Bucy syndrome receive complete inpatient care. A lack of anxiety or shame is as difficult to manage in everyday life as sudden irritability or aggression. This can lead to danger for themselves and fellow human beings. The hyperoral behavior cannot be controlled. The only way to minimize the oral tendency is to administer various medications.
Outlook and prognosis
The prognosis of Klüver-Bucy syndrome is unfavorable. Scientists and researchers to date have not been able to provide a path to cure or freedom from symptoms. The lesions in the brain are irreparable and do not allow the patient to recover. Moreover, the syndrome often occurs in combination with other disorders that contribute to a deterioration of general health. The treatment of a sufferer is extensive and extremely complex, as are his or her symptoms.Through various therapeutic approaches, success is achieved in individual areas and improvements are produced. However, recovery is not possible. The behavioral patterns are to be optimized in a therapy, so that an interpersonal contact to relatives is made possible. In a treatment a long-term therapy is applied. Discontinuation of the prescribed medication leads to an immediate relapse and can cause life-threatening complications. Taking the medication can trigger additional side effects, which must be taken into account when making an overall prognosis. If Klüver-Bucy syndrome is diagnosed, hospitalization of the affected person is required. Without specific therapy, there is a risk of self-harm as well as an increase in existing symptoms. In addition, the patient poses a danger to other people because of his or her peculiarities in the behavioral area and must therefore be under appropriate supervision.
Prevention
Preventive measures cannot be taken in Klüver-Bucy syndrome. This syndrome develops as a consequence due to other underlying diseases. Because it is a sequelae, it is not possible to take measures in advance or to perform appropriate preventive examinations as in other diseases. If one of the underlying diseases already exists, it is possible to look for changes and indications by observing one’s own emotional experience. Attention should be paid to signs such as intensity of emotions and expressive behavior. In Klüver-Bucy syndrome, there is a lack of emotion with concurrent hyperactivity.
Follow-up
As a rule, the measures of aftercare in Klüver-Bucy syndrome are severely limited or not available to the affected person at all. In this disease, first and foremost, a comprehensive diagnosis and treatment is necessary to prevent further worsening of the symptoms. For this reason, a doctor should be contacted at the first symptoms and signs of the disease. The damage to the brain in this disease is usually irreparable, so that a complete cure of this disease can no longer occur. Those affected are therefore dependent in their lives and in everyday life on the lasting help and support of their own family and friends and acquaintances. Intensive and loving conversations are often necessary to prevent possible psychological upsets or depression. Cramps can be alleviated with the help of medication. The affected person should always observe the correct dosage and also regular intake of the medication. If there is any uncertainty or if there are any questions, a doctor should be consulted first. As a rule, the life expectancy of those affected by Klüver-Bucy syndrome is significantly reduced, so that they die relatively early.
What you can do yourself
The options for self-help are very limited for patients with Klüver-Bucy syndrome. The damage to the temporal lobes is considered incurable and cannot be changed even with self-help measures. The patient’s behavior is off the norm and cannot be controlled. The sense of fear is almost non-existent and the drive behavior cannot be controlled by the patient’s own efforts. On a day-to-day basis, only a good relationship of trust with family members and medical professionals can put a stop to the patient’s self-injurious behavior. In many cases, however, the family members need comprehensive psychological support in order to better cope with dealing with the patient. The emotional burden on the people in the social environment of someone suffering from Klüver-Bucy syndrome is enormous. Everyday life has to be organized according to the symptoms of the disease. It is recommended for the relatives to use the offer of stress-reducing methods. Due to the tissue damage in the brain, the patient lacks insight into the disease and the ability to change his behavior. The lack of understanding as well as the tendency to examine everything with the mouth cause interpersonal problems and increase the risk of the disease. Constant control and care of the patient is necessary so that he does not get into a life-threatening situation. The whole environment should be adapted to the patient’s needs to improve his quality of life.
