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

A 34-year-old man with a 10-year history of persistent auditory hallucinati ons and passivity delusions had failed to respond to a variety of conventio nal antipsychotic medications. He had a history of head trauma 8 years befo re the onset of psychiatric symptoms. Recent investigations revealed a post -traumatic infarct, situated in the left frontal lobe, on a magnetic resona nce imaging scan. Treatment with clozapine for more than 2 years resulted i n a marked improvement in his psychotic symptoms. The localization of the b rain lesion may be related to the etiology of his symptoms: and to the clin ical response to clozapine.