Vol. 7, No. 3, 2001 Page 3

Case study: Kleptomania points to frontal dysfunction

Two Swiss clinicians cite one of their cases as evidence that "kleptomania is a rare variant of impulse-control disorder that can be caused by right orbitomedial prefrontal damage."

Thomas Nyffeler and Marianne Regard say their patient, a 32-year-old man, developed kleptomania weeks after undergoing an operation at age 13 to remove a tumor. Prior to the surgery, they say, "the patient had never had an impulse to steal or to plan a theft." He also showed evidence of post-surgery deficits in concentration, visual processing, and conceptual thinking, as well as abnormal talkativeness and preoccupations. Despite hospitalizations and treatment with serotonin reuptake inhibitors (which appear to reduce kleptomania in some cases), the man continued to steal pencils, stamps, and other items of little value, and was arrested and convicted several times. Medical evaluation, the researchers say, revealed impairments consistent with right hemisphere frontotemporal dysfunction.

The researchers say that clinical findings by other researchers "suggest that disruptions of orbitomedial prefrontal circuits constitute a predisposing factor for the development of disorders of the compulsive-addictive spectrum, such as kleptomania." They note that damage to this area is also associated with "utilization behavior", in which patients feel compelled to grasp and use objects they see (for instance, an ashtray or pencil lying on a table).

"We argue," the researchers say, "that kleptomania is a rare variant of impulse-control disorder that can be caused by right orbitomedial prefrontal damage," possibly involving altered neurotransmitter function.


"Kleptomania in a patient with a right frontolimbic lesion," Thomas Nyffeler and Marianne Regard, Neuropsychiatry, Neuropsychology, and Behavioral Neurology, Vol. 14, No. 1, 2001, pp. 73-76. Address: Marianne Regard, Department of Neurology, University Hospital Zurich, CH-8090 Zurich, Switzerland.

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