A vanishing lesion in the temporal lobe associated with schizophrenialike psychosis and catatonia.
OBJECTIVE
To present the case of a patient with hallucinations and psychotic symptoms that co-occurs with a temporary lesion in the left posterior temporal lobe.


BACKGROUND
Psychosis and auditory hallucinations are characteristic features of schizophrenia, but may also complicate many somatic diseases. Current functional imaging studies suggest a role of the temporal lobes.


METHODS
We describe a patient who initially presented with schizophrenialike psychotic symptoms at an age of 23. She did not respond to antipsychotic medication and developed severe medication-resistant catatonia.


RESULTS
Magnetic resonance imaging studies revealed an opaque left temporal lesion that could not be diagnosed otherwise. Electroconvulsive therapy led to remission of her catatonic and psychotic symptoms. After clinical remission, the temporal lesion had vanished.


CONCLUSIONS
The longitudinal association between the lesion and the occurrence and disappearance of psychosis supports current theories on the role of the left temporal lobe in psychosis.
Kho
Kuan H
KH
Department of Neurosurgery, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands. k.h.kho@umcutrecht.nl
van Veelen
Nicoletta M J
NM
Beerepoot
Lucas J
LJ
Sommer
Iris E C
IE
D000328:Adult; D000374:Aggression / Q000502:physiology; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001927:Brain Diseases / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D002389:Catatonia / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D003702:Delusions / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D038524:Diffusion Magnetic Resonance Imaging; D004292:Dominance, Cerebral / Q000502:physiology*; D004351:Drug Resistance; D004565:Electroconvulsive Therapy; D005260:Female; D005500:Follow-Up Studies; D006212:Hallucinations / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008140:Lorazepam / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D010259:Paranoid Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D019233:Retreatment; D013702:Temporal Lobe / Q000473:pathology / Q000503:physiopathology*
D014150:Antipsychotic Agents; D008140:Lorazepam