Objective: The aetiology of primary erotomania is usually discussed in terms of psychological disturbance in the patient. A case associated with demonstrable left temporal lobe abnormalities is described.
Clinical picture: An elderly female patient presented with the delusion of being loved by a physician who had treated her previously. She had received radiotherapy to her left periorbital area in childhood. Structural and functional neuroimaging revealed medial temporal lobe damage.
Treatment and outcome: She was treated with haloperidol with moderate improvement in her distress.
Conclusions: This case illustrates the contribution of both cerebral injury and psychosocial factors in the eventual development of this unusual psychiatric syndrome.
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