Gourmand Syndrome

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

Historical Perspective

• There is limited information about the historical perspective of gourmand syndrome.
• 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.

Classification

• There is no established system for the classification of gourmand syndrome.

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.
• Right middle cerebral artery hemorrhagic infarction, including lesion to the right internal capsule and basal ganglia
• 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.

Clinical Features

• Clinical features of Gourmand syndrome ranges from
  • Reduced to excessive appetite
  • Hunger dysregulation
  • Satiety signal dysregulation

Epidemiology and Demographics

• There is no information on the prevalence of gourmand syndrome.

Age

• Gourmand syndrome is more commonly observed among patients aged 15-77years old.

Gender

• Gourmand syndrome affects men and women equally.

Race

• There is no racial predilection for gourmand syndrome

Risk Factors

Common risk factors in the development of Gourmand syndrome are

• Vascular
  • Infarction
  • Malformations
  • AVM
  • Aneurysm
• Brain tumor
  • Glioma
  • Meningioma
  • Tuberculoma
• Trauma
  • Concussion with haemorrhage
• Epilepsy
  • Hippocampal sclerosis
  • Cortical dysplasia

Diagnosis

Diagnostic Criteria

• The diagnosis of gourmand syndrome is made when there is a change in eating behavior post brain trauma.

Symptoms

Symptoms of Gourmand syndrome may include the following:

• Outgoing and eating-oriented behavior
• Aroused only by conversations about food
• 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.
• 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

• Cerebral hemisphere
• Internal capsule
• Basal ganglia

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: Neurology)

Other Diagnostic Studies

• There is no diagnostic study for gourmand syndrome.

Treatment

Medical Therapy

Surgery

Prevention

References

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