Persistent Kluver-Bucy syndrome after bilateral thalamic infarction

Objective: To describe a patient who exhibited a partial Kluver-Bucy syndro me after small bilateral ischemic lesions in the thalami. Background: Previ ously reported patients with Kluver-Bucy syndrome had very large, mostly bi lateral lesions in the limbic system and could not provide sufficient infor mation about its, anatomo-functional correlate. Method: Behavioral assessme nts and clinical examinations, including magnetic resonance imaging and pos itron emission tomography, were conducted. Results: The patient: was severe ly amnestic, distractible, hyperoral, and affectively dyscontrolled, and sh e behaved socially inappropriately. Magnetic resonance imaging showed bilat eral infarctions in the territories of both thalamoperforating arteries, an d positron emission tomography revealed bilaterally decreased fluorodeoxygl ucose uptake in the anterior parts of the ventral thalami and, to a lesser extent, in the fronto-temporal cortices. Conclusions: This behavioral syndr ome has not yet been reported with isolated diencephalic lesions, but it ha s been observed after bilateral temporal lobe lesions. The authors conjectu re 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 emo tions.