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A Vanishing Lesion in the Temporal Lobe Associated With Schizophrenialike Psychosis and Catatonia

Kho, Kuan H. MD*; van Veelen, Nicoletta M. J. MD; Beerepoot, Lucas J. MD; Sommer, Iris E. C. MD, PhD

Cognitive and Behavioral Neurology: December 2007 - Volume 20 - Issue 4 - p 232-234
doi: 10.1097/WNN.0b013e31814d659c
Case Reports
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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.

Method 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.

Departments of *Neurosurgery

Psychiatry

Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands

The patient gave informed consent for description of her medical history and MRI scans in a medical journal.

Reprints: Kuan H. Kho, MD, Department of Neurosurgery, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands (e-mail: k.h.kho@umcutrecht.nl).

Received for publication June 5, 2007; accepted July 5, 2007

© 2007 Lippincott Williams & Wilkins, Inc.