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Ganser Syndrome: Differential Diagnoses & Workup
Updated: Jan 22, 2009
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
Differential Diagnoses
Other Problems to Be Considered
Encephalitis
Epilepsy
Frontal-temporal dementia
Huntington disease
Workup
Laboratory Studies
Standard medical workup should include the following:
- CBC count with differential
- Basic metabolic panel
- Liver function test (and ammonia level if clinically indicated)
- Erythrocyte sedimentation rate
- Thyroid function tests
- Vitamin B-12 levels
- Rapid plasma reagent (RPR) test
Imaging Studies
Consider a CT scan or MRI to rule out possible cerebral pathology as indicated.
Other Tests
An electroencephalogram can be performed to rule out seizure disorder or evidence of delirium.
Procedures
Consider performing a lumbar puncture if clinically indicated since meningitis and encephalitis can cause the syndrome.
More on Ganser Syndrome |
| Overview: Ganser Syndrome |
Differential Diagnoses & Workup: Ganser Syndrome |
| Treatment & Medication: Ganser Syndrome |
| Follow-up: Ganser Syndrome |
| References |
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References
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision. Washington, DC: American Psychiatric Association; 2000.
Ruggles AH. Observations on Ganser's Syndrome. American Journal of Insanity. 1905;62:307-311.
Enoch MD, Trethowan WH. The Ganser syndrome. Uncommon Psychiatric Syndromes. 1979;50-62.
Snyder SL, Buchsbaum MS, Krishna RC. Unusual visual symptoms and Ganser-like state due to cerebral injury: a case study using (18)F-deoxyglucose positron emission tomography. Behav Neurol. 1998;11(1):51-54. [Medline].
Merckelbach H, Peters M, Jelicic M, Brands I, Smeets T. Detecting malingering of Ganser-like symptoms with tests: a case study. Psychiatry Clin Neurosci. Oct 2006;60(5):636-8. [Medline].
Andersen HS, Sestoft D, Lillebaek T. Ganser syndrome after solitary confinement in prison: a short review and a case report. Nord J Psychiatry. 2001;55(3):199-201. [Medline].
Carney MW, Chary TK, Robotis P. Ganser syndrome and its management. Br J Psychiatry. Nov 1987;151:697-700. [Medline].
Dalfen AK, Anthony F. Head injury, dissociation and the Ganser syndrome. Brain Inj. Dec 2000;14(12):1101-5. [Medline].
Epstein RS. Ganser syndrome, trance logic, and the question of malingering. Psychiatric Annals. Apr 1991;21(4):238-44.
Ladowsky-Brooks RL, Fischer CE. Ganser symptoms in a case of frontal-temporal lobe dementia: is there a common neural substrate?. J Clin Exp Neuropsychol. Sep 2003;25(6):761-8. [Medline].
Lee HB, Koenig T. A case of Ganser syndrome: organic or hysterical?. Gen Hosp Psychiatry. Jul-Aug 2001;23(4):230-1. [Medline].
McEvoy, Campbell T. Ganser-like signs in carbon monoxide encephalopathy. Am J Psychiatry. Dec 1977;134(12):1448-9. [Medline].
Miller P, Bramble D, Buxton N. Case study: Ganser syndrome in children and adolescents. J Am Acad Child Adolesc Psychiatry. Jan 1997;36(1):112-5. [Medline].
Shorer CE. The Ganser Syndrome. British Journal of Criminology. Apr 1965;5:120-131.
Sigal M, Altmark D, Alfici S. Ganser syndrome: a review of 15 cases. Compr Psychiatry. Mar-Apr 1992;33(2):134-8. [Medline].
Tost H, Wendt CS, Schmitt A, Heinz A, Braus DF. Huntington's disease: phenomenological diversity of a neuropsychiatric condition that challenges traditional concepts in neurology and psychiatry. Am J Psychiatry. Jan 2004;161(1):28-34. [Medline].
Further Reading
Keywords
Ganser syndrome, Ganser's syndrome, psychotic episodes, psychotic illness, psychosis, clouding of consciousness, inattentiveness, drowsiness, hysterical paralysis, hallucinations, hysteria, malingering, alcoholism, head injury, epilepsy, stroke, cerebral infection, dissociative disorder, factitious disorder, amnesia, psychosocial stress, vorbeireden, echolalia, echopraxia, confusion
Differential Diagnoses & Workup: Ganser Syndrome