Gourmand Syndrome, first described in 1997, leads to an obsession with the quality and preparation of food after a brain injury.
Currently we know many types of eating disorders, all of them classified as psychiatric disorders to use (that is, there is no manifest brain injury that causes them). Among them are nervous anorexia and bulimia, known on the Internet as " Ana y Mía ", although there are many other disorders such as orthorexia (pathological need to eat extremely healthy), megarexia (obese who look healthy and thin) or the drunkorexia (eat little to drink more alcohol without gaining weight).
But what about disorders that do have a neurological basis? With a neurological basis, I mean brain injuries, either due to vascular damage (a stroke for example), or tumors. The reality is that, despite how “much” we know about the human brain, there are still many things that we do not know about it. And so it became clear in 1997, when Landis and Regard described two clinical cases that are still classified as very rare syndromes today: Gourmand syndrome, the brain disorder that makes you a gourmet (with all its consequences) .
What is Gourmand syndrome?
If we look at the definition of gourmet, we will see that the term refers to an individual who enjoys eating refined and exquisitely prepared foods. A gourmet is someone with a very select palate and very specific gastronomic tastes.
On the other hand, a gourmand is similar, but in his case, he is an individual who derives pleasure from food, but is very sweet, and tends to excess. It would be an intermediate step between the gourmet and the glutton so to speak.
In the case of Gourmand syndrome, first described in 1997 by Marianne Regard (neuropsychologist) and Theodor Landis (neurologist), it is an eating disorder secondary to brain damage. It can occur in both children and adults, but it is considered a " benign disorder ", since the only consequence of suffering the disorder is the change in relationship with food: patients who suffer from it think a lot about food, they argue about food They write about food and above all they eat a lot; Of course, they do not eat anything, as they tend to have specific and very select cravings, always looking for a high quality in said dish (sophistication and good preparation).
In the first description of this disorder, Regard and Landis described two different cases. The first of them was a journalist specializing in politics who, after suffering a stroke with a full recovery, began to suffer a sudden interest in sophisticated food that he did not previously have. He completely changed jobs and started a new career as a food critic specializing in restaurants and select food, so the disorder did not feel so bad for him.
The second case described was that of a business shoulder who, also after suffering a stroke, developed a sudden passion for the finest food. However, in this case there was a greater alteration of his impulse control, and this individual also carried out constant sexual harassments to the nurses of the hospital where he was admitted. In fact, a subsequent study by Regard and Landis from 2003, where 21 gamblers were studied, found that up to 8 of these individuals also suffered from gourmand syndrome, which would suggest that both disorders (compulsive gambling and gourmand syndrome) have similarities such as pleasure seeking, obsessive behaviors, and impulse control problems.
How is Gourmand syndrome diagnosed?
To arrive at the diagnosis of Gourmand syndrome, Regard and Landis established a series of criteria, both at the behavioral level and at the anatomopathological level (the lesions detected in the brain tissues analyzed):
· There must be a sudden change in eating habits, especially in terms of the search for quality and preparation of them. This change must be related to brain lesions not previously present, without previously known neurological or psychiatric disorders in the individual studied.
· The brain lesions are usually located in the right hemisphere (94% of the cases studied with Gourmand meet this criterion syndrome). Specifically, in the temporal lobe, around the limbic system and the basal ganglia; These areas have been linked to emotions and motivation. Also, to a lesser extent, there are also lesions in the frontal lobe, in the decision-making and personality area; and in the parietal lobe.
· The main cause of the lesions is usually a tumor, but it can also be due to an originating focus of epileptic seizures, a head trauma, a cerebral hemorrhage or a cerebrovascular accident.
Other cases of Gourmand syndrome
Although the first described cases of Gourmand syndrome were after cerebrovascular accidents, and that most of the later cases described have been due to tumors as we have already mentioned, in 2008 Mary Kurian and her colleagues published the case of a boy from ten years with epilepsy resistant to medical treatment that was finally also diagnosed with Gourmand syndrome.
In this case, the boy was diagnosed with epilepsy when he was eight years old, but at the same time he developed an increased appetite and a taste for cooking, with a certain obsession in creating new recipes. He also showed a curious obsession with the quality of food, and used to prefer to cook for him instead of going too fast-food places with his friends.
The curious thing is that the boy had never received a gastronomic education or had been taught to cook. He had no prior history of eating disorders or of neurological or psychiatric disorders in general. And, to curl the curl, according to the electroencephalogram that was performed, the focus of his epilepsy was located exactly in the parietoccipital region of the right hemisphere. It met all the criteria mentioned by Regard and Landis.
According to the authors of the case report, the focus of the epilepsy suffered by the child could have produced an increase in neuronal activity that would have generated this new behavior in front of food. Later, when this boy's epilepsy was controlled, the behaviors associated with Gourmand syndrome disappeared.
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