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Manic-like state after bilateral orbitofrontal and right temporoparietal injury

Efficacy of clonidine

Service de Neurologie et Neuropsychologie, Hòpital de la Salpêtrière. 47, boulevard de l'Hòpital. F-75651 Paris Cedex 13 (Dr. Bakchine, N. Benoit, D. Parisot, Drs. Chain and Lhennitte)
Département de Pharmacologie Clinique, Hòpital de la Salpêtrière. 47, boulevard de l'Hòpital. F-75651 Paris Cedex 13 (Dr. Lacomblez).

A manic-like state occurred in a 44-year-old right-handed woman with bilateral orbitofrontal and right temporoparietal traumatic contusions. In a brief trial, we assessed the effect of clonidine, carbamazepine, dopa therapy, and placebo on manic symptoms and cognitive functions. Clonidine rapidly reversed the manic syndrome. The patient's behavior did not change with carbamazepine and worsened with levodopa. We suggest that the manic-like syndrome was related to noradrenergic overactivity secondary to the fronto-orbital lesions.

Address correspondence and reprint requests to Dr. Bakchine, Service de Neurologie et Neuropsychologie, Centre du Langage (Pr Chain), La Salpêtrière. 47, Bvd de l'Hòpital, F78651 Paris Cedex 13, France.

Received August 29, 1988. Accepted for publication in final form December 9, 1988.

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