Acquired Sexual Paraphilia in Patients With Multiple Sclerosis
Elliot M. Frohman, MD, PhD;
Teresa C. Frohman, BA;
Ann M. Moreault, PhD
Arch Neurol. 2002;59:1006-1010.
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.
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.
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