title: Masturbation in infancy and early childhood presenting as a movement disorder: 12 cases and a review of the literature.
abstract: OBJECTIVE
  Infantile masturbation (gratification behavior) is not commonly identified as a cause of recurrent paroxysmal movements. Extensive and fruitless investigations may be pursued before establishing this diagnosis. Sparse literature is available regarding masturbatory behavior as a whole, but literature available as case reports describes common features. The purpose of this case series is to describe consistent features in young children with posturing accompanying masturbation.
  
  
  METHODS
  Twelve patients presenting to a pediatric movement disorders clinic with a suspected movement disorder were determined to have postures and movements associated with masturbation. We reviewed the clinical history, examination, and home videotapes of these patients.
  
  
  RESULTS
  Our patients had several features in common: (1) onset after the age of 3 months and before 3 years; (2) stereotyped episodes of variable duration; (3) vocalizations with quiet grunting; (4) facial flushing with diaphoresis; (5) pressure on the perineum with characteristic posturing of the lower extremities; (6) no alteration of consciousness; (7) cessation with distraction; (8) normal examination; and (9) normal laboratory studies.
  
  
  CONCLUSIONS
  The identification of these common features by primary care providers should assist in making this diagnosis and eliminate the need for extensive, unnecessary testing. Direct observation of the events is crucial, and the video camera is a useful tool that may help in the identification of masturbatory behavior.
authors.affiliation: Department of Child Neurology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Michele L
authors.initials: ML
authors.lastname: Yang
authors.forename: Erika
authors.initials: E
authors.lastname: Fullwood
authors.forename: Joshua
authors.initials: J
authors.lastname: Goldstein
authors.forename: Jonathan W
authors.initials: JW
authors.lastname: Mink
mesh_terms: D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D008418:Masturbation / Q000175:diagnosis*; D009069:Movement Disorders / Q000175:diagnosis*