Genital and sexual manifestations in drug-resistant partial epilepsy.
Genital and sexual manifestations represent rare clinical phenomena during or after focal seizures. The semiology of these types of automatisms is controversial. In particular, it is unclear whether temporal or frontal structures are involved in their generation and whether these clinical manifestations have a potential lateralizing value. In this view, from a population of 212 consecutive patients with drug resistant focal epilepsy referred to us for presurgical assessment, we retrospectively identified 24 patients with genital ictal manifestations. We evaluated the incidence of these behaviours, the clinical semiology, the associated symptoms/signs with the corresponding ictal EEG findings and their potential role in lateralizing the epileptogenic zone. Our results indicate that ictal genital automatisms are possible in seizures originating from temporal lobe and they cannot be attributed exclusively to frontal lobe seizures. In particular, the most frequent genital automatisms consist in subtle phenomena while hypermotoric behaviour, such as pelvic rhythmic movements are quite rare. No lateralizing value for genital automatisms was disclosed.
Mascia
Addolorata
A
Epilepsy Surgery Unit, Department of Neurosciences, IRCCS NEUROMED, Pozzilli, IS, Italy. episurg@neuromed.it
Di Gennaro
Giancarlo
G
Esposito
Vincenzo
V
Grammaldo
Liliana G
LG
Meldolesi
Giulio N
GN
Giampà
Teresa
T
Sebastiano
Fabio
F
Falco
Carolina
C
Onorati
Paolo
P
Manfredi
Mario
M
Cantore
Giampaolo
G
Quarato
Pier Paolo
PP
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D001332:Automatism / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D004351:Drug Resistance; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology*; D005260:Female; D005625:Frontal Lobe / Q000473:pathology / Q000503:physiopathology; D007839:Functional Laterality / Q000502:physiology; D005835:Genitalia / Q000503:physiopathology*; D006801:Humans; D006948:Hyperkinesis / Q000503:physiopathology*; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012725:Sexual Behavior / Q000502:physiology*; D013702:Temporal Lobe / Q000473:pathology / Q000503:physiopathology
D000927:Anticonvulsants