572 JONES AND KERWIN a pattern seen in our patient's CT scan. This would result in impaired verbal learning and language function but normal processing of spatial information, as seen in autism. It is well known that the incidence of obstetric complications is increased in autism (Gillberg & Gillberg, 1983) and that medial temporal lobe structures may be particularly susceptible to perinatal hypoxia (Brown & Brierley, 1973). Temporal lobe pathology has been demonstrated in several conditions having features in common with Asperger's syndrome, including TLE (Flor-Henry, 1969), schizophrenia (Slater et a!, 1963), Korsakoff's psychosis (Hetzler & Griffen, 1981), and Kluver—Bucy syndrome (Dc Long, 1978). We present direct evidence of left temporal lobe pathology in a case of Asperger's syndrome. Although the neural mechanism involved cannot be elucidated, this case adds further weight to the notion of autism as a temporal lobe disorder. Acknowledgements We thank Professor M. Shepherd and Dr I. Falloon for allowing us to present their case and Janet Yatak for her secretarial help. References BAUMAN, M. & KEMPER, 1. L. (1985) Histoanatomic observations of the brain in early infantile autism. Neurology, 35, 866—874. BROWN, A. W. & BRIERLEY. J. B. (1973) The earliest alterations in ratneuronesand astrocytes afteranoxia-ischaemia. Acta Neuropathologica, 23, 9-22. CREASEY, H., RUM5EY, J. M., SCHWARTZ, M., et al (1986) Brain morphometry in autistic men as measured by volumetric computed tomography. Archives of Neurology, 43, 669-672. DE LONG,G. R. (1978) A neuropsychologic interpretation of infantile autism.InAutism:AReappraisal ofConceptsand Treatment (edsM.Rutter & E.Schopter). New York:Plenum. FLOR-HENRY, P. (1969) Psychosis and temporal lobe epilepsy. Epilepsia, 10, 363—395. GAFFNEY, G. R., KUPERMAN, S., LUKE, Y. T., et al (1987) Midsaggital magnetic resonance imaging of autism. British Journal of Psychiatry, 151, 831-833. GILLBERG,C., SVENNERHOLM, L. & HAMILTON-HELLBERG, C. (1983) Childhood psychosis and monoamino metabolites in spinal fluid. Journal of Autism and Developmental Disorders, 13, 181—195. GILLBERG, C. & GILLBERG,I. C. (1983) Infantile autism: a total populationstudy of reducedoptimalityin the pre-, pen- and neonatal period. Journal of Autism and Developmental Disorders, 13, 153—156. HAUSER, S. I., D@ LONG, G. R. & ROSMAH, N. P. (1975) Pneumographic findings in the infantile autistic syndrome —¿ a correlationwith temporal lobe disease.Brain, 98, 667—688. HETZLER, B. & GRIFFIN, J. (1981) Infantile autism and the temporal lobe of the brain. Journal of Autism and Developmental Disorders, 11, 317—330. PRIOR, M. (1987) Biological and neurological approaches to childhood autism. British Journal of Psychiatry, 150, 8—17. RU1-FER, M. (1974) The development of infantile autism. Psycho logical Medicine, 4, 147—163. SKOFF,B., MIRSKY,A. & TURNER, D. (1980) Prolonged brainstem transmission time in autism. Psychiatry Research, 2, 157—166. SLATER,E., BEARD, A. & GLITHERO, E. (1963) Schizophrenia-like psychoses of epilepsy. British Journal of Psychiatry, 109,95-150. WING, L. (1981) Asperger's syndrome: a clinical account. Psychological Medicine, 11, 115—129. *P. B. Jones, BSc,MRCP, Research Psychiatrist, Genetics Section, Institute of Psychiatry, de Crespigny Park, Denmark Hill, London 5E5 8AF; R. W. Kerwin, MA, PhD, MRCPsych,Honorary Lecturer, Institute of Psychiatry and Honorary Senior Registrar, Mauds!ey Hospital, London *Correspondence British Journal of Psychiatry (1990), 156, 572—575 Organic Affective Psychosis Associated with the Routine Use of Non-prescription Cold Preparations TERRY M. BROWN, ROBERT N. GOLDEN and DWIGHT L. EVANS A patientexperiencedanorganicaffective psychosisonthreeseparateoccasionsaftertaking recommended doses of non-prescription cold/sinus preparations. The possible underlying pharmacological mechanisms of this clinical reaction lend support to the cholinergic-adrenergic balance hypothesis of affective disorders. Recognition of this acute drug-induced state can