Search tips
Search criteria 


Logo of jpnSubmit a ManuscriptEmail AlertsAbout JPNJournal of Psychiatry and Neuroscience
J Psychiatry Neurosci. 1999 November; 24(5): 456–461.
PMCID: PMC1189060

Refractory symptomatic schizophrenia resulting from frontal lobe lesion: response to clozapine.


A 34-year-old man with a 10-year history of persistent auditory hallucinations and passivity delusions had failed to respond to a variety of conventional antipsychotic medications. He had a history of head trauma 8 years before the onset of psychiatric symptoms. Recent investigations revealed a post-traumatic infarct, situated in the left frontal lobe, on a magnetic resonance imaging scan. Treatment with clozapine for more than 2 years resulted in a marked improvement in his psychotic symptoms. The localization of the brain lesion may be related to the etiology of his symptoms and to the clinical response to clozapine.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.4M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Images in this article

Click on the image to see a larger version.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Flor-Henry P. Lateralized temporal-limbic dysfunction and psychopathology. Ann N Y Acad Sci. 1976;280:777–797. [PubMed]
  • Flor-Henry P, Koles ZJ. Studies in right/left hemispheric energy oscillations in schizophrenia, mania, depression, and normals [proceedings]. Psychopharmacol Bull. 1980 Oct;16(4):52–53. [PubMed]
  • Achté KA, Hillbom E, Aalberg V. Psychoses following war brain injuries. Acta Psychiatr Scand. 1969;45(1):1–18. [PubMed]
  • Paulesu E, Frith CD, Frackowiak RS. The neural correlates of the verbal component of working memory. Nature. 1993 Mar 25;362(6418):342–345. [PubMed]
  • McGuire PK, Shah GM, Murray RM. Increased blood flow in Broca's area during auditory hallucinations in schizophrenia. Lancet. 1993 Sep 18;342(8873):703–706. [PubMed]
  • Kane J, Honigfeld G, Singer J, Meltzer H. Clozapine for the treatment-resistant schizophrenic. A double-blind comparison with chlorpromazine. Arch Gen Psychiatry. 1988 Sep;45(9):789–796. [PubMed]
  • Kennard C, Crawford TJ, Henderson L. A pathophysiological approach to saccadic eye movements in neurological and psychiatric disease. J Neurol Neurosurg Psychiatry. 1994 Aug;57(8):881–885. [PMC free article] [PubMed]
  • Starkstein SE, Bryer JB, Berthier ML, Cohen B, Price TR, Robinson RG. Depression after stroke: the importance of cerebral hemisphere asymmetries. J Neuropsychiatry Clin Neurosci. 1991 Summer;3(3):276–285. [PubMed]
  • Hall DP, Young SA. Frontal lobe cerebral aneurysm rupture presenting as psychosis. J Neurol Neurosurg Psychiatry. 1992 Dec;55(12):1207–1208. [PMC free article] [PubMed]
  • Brooks WM, Hodde-Vargas J, Vargas LA, Yeo RA, Ford CC, Hendren RL. Frontal lobe of children with schizophrenia spectrum disorders: a proton magnetic resonance spectroscopic study. Biol Psychiatry. 1998 Feb 15;43(4):263–269. [PubMed]
  • Denney D, Stevens JR. Clozapine and seizures. Biol Psychiatry. 1995 Apr 1;37(7):427–433. [PubMed]
  • Noda H, Sato H, Ikeda Y, Sugita S. Fastigiofugal fibers encoding horizontal and vertical components of saccades as determined by microstimulation in monkeys. Neurosci Res. 1992 Apr;13(3):163–173. [PubMed]

Articles from Journal of Psychiatry & Neuroscience : JPN are provided here courtesy of Canadian Medical Association