Successful treatment of an adult with symptomatic attention deficit, hyperactivity, and impulsivity after temporal lobe resection: case report.

Abstract

Attention deficit hyperactivity disorder (ADHD) is defined by inattentiveness, impulsivity, and/or hyperactivity and mandatorily requires an onset in childhood. Structural or functional anatomical abnormalities have mostly been found in the prefrontal cortex, the corpus callosum, the striatum, and the cerebellum. We here present the case of an adult woman who developed severe symptoms analogous to ADHD after right temporal lobectomy. Surgery had been necessary because of a large temporobasal arterio-venous malformation (AVM). The patient's childhood and personal history before surgery had been without any indication of ADHD or any other mental disorder. Because of her distinct and impairing symptoms of ADHD, we initiated off-label methylphenidate treatment, achieving strong reduction in the symptoms. This proves further similarity of her symptomatic disorder to ADHD and supports a role of the right temporal lobe in ADHD.