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.

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

Age

Gender

Race

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

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

Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Prevention

References

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