Hoigné's syndrome: a procaine-induced limbic kindling.

Procaine-induced limbic kindling may be a principal pathogenetic factor for the psychiatric symptoms of the acute non-allergic reaction to procaine penicillin (Hoigné's syndrome). The syndrome develops with repeated injections of the drug and runs a rapidly spasmodic course. Its acute symptoms (anxiety, perceptual disturbances, sympathetic hyperactivity) are similar to those in temporal lobe and limbic system seizures and are also reminiscent of psychiatric complications following the repeated use of other local anesthetics (lidocaine, cocaine). Compatible with the mechanisms of kindling are also possible predispositions to the occurrence of this reaction as well as the recurrent after-effects during follow-up. Penicillin, a second component of the injection may contribute to the development of kindling by its properties of antagonizing GABA neurotransmission.