We present a young woman with clozapine-resistant schizoaffective disorder who was treated with maintenance electroconvulsive therapy and multiple antipsychotics but continued to have auditory hallucinations. She had a haemorrhagic stroke secondary to a ruptured arteriovenous malformation at the right superior temporal gyrus, which was excised during emergency craniotomy. Despite having neurological deficits after the stroke, she reported cessation of auditory hallucinations. Magnetic resonance imaging of the brain showed Wallerian degeneration over the right temporal region. Personalised neuromodulation intervention may be a more effective treatment option for clozapine-resistant schizophrenia.
Keywords: Clozapine; Hallucinations; Schizophrenia.