Temporal Lobe Epilepsy with Sexual Manifestation, a Case Report

Abstract

BackgroundTemporal lobe epilepsy with prevalence of 0.003 is the most common type of epilepsy in adulthood. 20-60% of these patients have psychiatric co morbidity and 30% of them have a history of admission in psychiatric hospitals, before referring to neurologist. Case presentation: The case is a 22 years old, single and high school educated man who developed his first epileptic episode four years ago when he was student in spiritual sciences center, so he was captured and suspended his education because of sexual manifestation of epilepsy. Then he was referred to a psychiatrist for management as a case of psychiatric illness but there was no improvement after one year of psychopharmacotherapy and following a suicidal attempt he was admitted in hospital and took ECT with the impression of mood disorder but in out patient service follow up he talked about the true nature of his problem and in a case conference session with the presence of psychiatrists and neurologist, we noticed that he is a case of epilepsy that his epileptic episodes usually occur in public places, 2-3 times in a year, no matter what is the victim sexuality. Each episode lasts about few minutes with postictal confusion and the patient has no memory about the episodes. Between the episodes the patient suffers from anxiety and depression. EEG was abnormal but brain CT scan and MRI with contrast were normal. After antiepileptic management the patient had no epileptic episode during one year follow up period. Conclusionevaluation of sexual manifestation in the context of anxiety and depressive state need more consideration because it could be a distinct entity rather than a psychological manifestation.