Psychopathology of Ganser's syndrome. Literature review and case report

Wirtz, G; Baas, U; Hofer, H; Nyffeler, T; Seifritz, E; Müri, René Martin; Gutbrod, Klemens (2008). Psychopathology of Ganser's syndrome. Literature review and case report. Nervenarzt, 79(5), pp. 543-547. Heidelberg: Springer-Verlag 10.1007/s00115-008-2411-8

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The key feature of Ganser's syndrome includes approximate answers to simple questions. The cause of this rare syndrome remains uncertain. Current classification systems categorise it as a dissociative disorder, the symptoms of which are judged as psychogenic in origin. Our review of the literature (n=151) demonstrates however that Ganser's syndrome is frequently associated with brain injury, although detailed imaging, neuropsychological, and neurological data of this for the most part do not exist. We describe a right-handed patient with Ganser's syndrome after a large left-hemispheric middle cerebral artery infarction. Detailed neuropsychological examination showed atypical lateralisation of cognitive functions with so-called crossed nonaphasia and pronounced frontal-executive dysfunctions. Regarding both psychiatric and neuropsychological aspects, we discuss how the key feature of approximate answers may be associated with frontal-executive cerebral dysfunctions.

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