Summary:Severe compulsive hand-washing accompanied by affective disorders and fear of contamination were observed in a case with bilateral caudate atrophy demonstrated on magnetic resonance imaging (MRI) scan. As the frontal lobe atrophy progressed, the fear of contamination and compulsive hand-washing disappeared while the compulsive eating of food and nonfood items developed together with a cognitive decline and affective disturbances. The clinical features of compulsive eating were similar to cases of the Kluver–Bucy syndrome in humans usually associated with temporal lobe lesions. However, the MRI scans in the present case showed a prominent progressive atrophy in the caudate nuclei and the frontal lobes while the temporal lobes were spared