Gourmand-Like Syndrome With Sugar Preference Following Parieto-Occipital Metastasis: A Neuropsychiatric Case Report
A. Bansal, P. Verma, M. GuptaIntroduction
Gourmand Syndrome is a rare neuropsychiatric condition characterized by new-onset, intense preoccupation with specific foods, often sweets, following focal brain lesions involving the right anterior insula, orbitofrontal cortex, or their connections (Regard & Landis, Eur Neurol 1997;37:236–240). While most reported cases follow right-hemisphere involvement, mass effect from contralateral lesions may produce similar behavioral changes (Mendez et al., J Neuropsychiatry Clin Neurosci 2007;19:444–449). We present a dementia case in which persistent sugar craving and selective food aversion emerged after left parieto-occipital metastasis with mass effect on right-hemispheric reward circuits.
Objectives
To present a rare case of late-life dementia with prominent sugar craving and food selectivity, occurring after a left parieto-occipital metastasis exerting mass effect on right-hemispheric gustatory–reward circuits.
Methods
An observational case study was conducted, integrating neuroimaging findings, clinical psychiatric evaluation, caregiver reports, and behavioral analysis over a three-month follow-up. MRI brain scans before and after stereotactic radiotherapy were reviewed to assess lesion evolution and anatomical involvement
Results
An 89-year-old male with no psychiatric history, with adenocarcinoma treated in 2021 (4 years back), developed seizures and subsequent cognitive decline following hyponatremia. Neuroimaging revealed a left occipital metastasis with edema and progressive midline shift toward the right hemisphere. Post-radiotherapy, caregivers reported persistent, compulsive sugar intake (~100g/day), aversion to salty foods, and behavioral rigidity around meal choices. No mood, psychotic, or obsessive-compulsive symptoms were observed. Findings suggest disruption of right orbitofrontal–insular–limbic connectivity via mass effect, producing a hedonic shift in dietary preference consistent with Gourmand Syndrome.
Image 1: Long description.