Acute atypical psychosis following a right hemisphere stroke.

An acute atypical psychotic episode characterized by hallucinations and delusions suddenly developed in a 63-year-old right-handed male following an extensive right hemisphere infarction in the carotid artery distribution. While hallucinations were visual, tactile and auditory, delusions were associated with specific neurologic defects (anosognostic phenomenon, reduplication for place, body-parts and objects and confabulation). Distractibility, inappropriate sexual behavior, agitation or seizures were lacking. This case supports the presumption that the right hemisphere damage plays a major role in the genesis of organic psychotic episodes.