A 67 year old man has a recurrence of a grade 4, right parieto-occipital astrocytoma. He is radiated and treated with BCNU. After the fourth dose of chemotherapy, complex partial motor seizures appear. Carbamazepine is added to phénobarbital. After two weeks, in the interjetai periods, the patient begins to develop an unchangeable jealous delusion, without accompanying mood, hallucinations and
... [Show full abstract] consciousness disorders. The patient exhibits aggressive and violent behavior towards his wife. Psychiatric examination confirms paranoid state. Alcoholism, general paresis, and dementia are excluded. An unsuccessful attempt with haloperidol, 6 mg/day, is made. Clotiapine is then administered, 80-120 mg/day, with improvement of the delusion and without change in seizure frequency. The reported case shows that epilepsyrelated delusion is possible with lesions of the right hemisphere and not only with lesions of the left one. However the favouring action of carbamazepine, radiation or BCNU treatment on delusion, in our case, cannot be ruled out.