Acquired Sexual Paraphilia in Patients With Multiple Sclerosis | Demyelinating Disorders | JAMA Neurology | JAMA Network
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June 2002

Acquired Sexual Paraphilia in Patients With Multiple Sclerosis

Author Affiliations

From the Departments of Neurology (Dr Frohman and Ms Frohman), Ophthalmology (Dr Frohman), and Rehabilitation Science (Dr Moreault), The University of Texas Southwestern Medical Center at Dallas.

Arch Neurol. 2002;59(6):1006-1010. doi:10.1001/archneur.59.6.1006

Background  Sexual dysfunction in patients with multiple sclerosis is typically characterized by diminished libido, erectile and ejaculatory dysfunction in men, and poor lubrication and anorgasmy in women. In contrast, hypersexual behavior and paraphilias are distinctly uncommon in this population of patients, but have been associated with various focal brain lesions.

Patient and Methods  We describe a man with clinically definite multiple sclerosis who developed profound and abrupt disinhibition and paraphilic behavior during an exacerbation.

Results  Neuroimaging revealed a marked increase in the number of enhancing lesions in the right sides of the hypothalamus and mesencephalon and extending into the right sides of the red nucleus, substantia nigra, and internal capsule. The altered sexual behavior was characterized by an obsessive and insatiable desire to touch women's breasts.

Conclusions  Acquired sexual paraphilic behavior is uncommon in patients with multiple sclerosis but may occur when inflammatory demyelination involves the hypothalamic and septal regions of the basal prosencephalon. Our experience with this man illustrates the great difficulty involved in treating such patients when the paraphilic behavior becomes persistent.