Ganser Syndrome Following Acute Psychological Stress in a Patient with Organicity: Implications for Etiopathogenesis

Ganser syndrome is a rare dissociative disorder marked by approximate answers, amnesia, and conversion symptoms and is conventionally classified as a psychological disorder. This case report describes a 40-year-old female with episodic dissociative symptoms following psychological stressors, including disorientation, amnesia, and approximate answers, suggestive of Ganser syndrome. Her medical history revealed similar recurrent episodes since 2015, linked to family conflicts, alongside a diagnosis of migraine and magnetic resonance imaging findings of partial empty sella. The presence of an organic factor in this case triggered us to delve deeper into the topic. A review of literature suggests that Ganser syndrome is often associated with stressor factors and underlying somatic diseases. The possible role of partially empty sella, in this case, is considered, and we propose a neurobiological hypothesis regarding the etiopathogenesis of Ganser syndrome in this case, that subtle or overt organic pathology impairs the individual’s emotional response physiology, which decompensates under acute psychological stress.