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.

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.