Hypersexual behaviour is a recognized complication of head injuries which can be a source of great distress to patients and persons with whom these patients share significant relationships.
In this article, we describe 5 patients who exhibited aberrant sexual behaviours following traumatic brain injury and discuss the relevant literature.
Disorders of sexual function, even though relatively common following traumatic brain injury, have not received commensurate attention in the literature on the complications of head trauma. Sexual problems following injury are usually the result of interaction between Brain damage sexuality psychological makeup of the injured person, his sociocultural background and the neurological sequelae of the injury itself [ 1 ].
Hypersexuality is a rare but well recognised sequela of brain injury [ 2 ]. It has been defined as the subjective experience of loss of control over sexuality [ 3 ]; and consists of increased need or intense pressure for sexual gratification. It has been successfully produced in experimental animals [ 4 ]; and much of our current knowledge about the subject is the result of studies of non-traumatic brain injury [ 5 ].
Its occurrence therefore offers useful insight regarding the anatomical basis of normal human sexual behaviour and provides important evidence about the "Brain damage sexuality" basis of aberrant behaviours [ 6 ]. In this paper, the authors describe 5 patients in whom hypersexual behaviour manifested following traumatic brain injury.
Relevant literature on hypersexuality Brain damage sexuality brain injury is also reviewed.
A year-old male was admitted to the hospital in coma due to severe head injury following a road accident. He also sustained an open left femoral and left Cole's fractures.
His blood pressure, pulse and temperature were within normal limits. He had a Glasgow Coma score of 3 at the time of admission. Ocular examination revealed normal sized pupils, both of which reacted sluggishly to light. His limbs were flaccid and all tendon reflexes were depressed. Skull x-ray showed no bony injury. He remained deeply comatosed for seven weeks after which his level of consciousness started to improve gradually. By the end of the tenth week, he had recovered sufficiently to the extent where he could obey verbal commands, but remained aphasic until the twelfth week.
At this time, he began to manifest hypersexual behaviour. The latter was first signalled by the strong arousal anytime he was being attended to by female ward staff.
This was soon replaced by increasing agitation whenever a female was nearby; and subsequently-when his ability to verbalise returned-his unabashed demand for sex, and finally his attempt to grab a female attendant. Besides minor tranquilizer which was given on account of his agitation, no specific medication was administered to control his altered sexual behaviour. progressively became less agitated in the presence Brain damage sexuality female staff and by the end of the second week after onset of hypersexual behaviour, he had completely normalised.
A year-old married businessman was admitted in coma following a road traffic accident. He was said to have had seizures at the scene of accident and also while being transported "Brain damage sexuality" hospital.
His Glasgow coma score was 3. Tendon reflexes were Brain damage sexuality. There was evidence of a linear fracture of the right parietal bone on skull x-ray.
The brain was normal on CT brain. There was no intracranial collection. Patient fully regained consciousness after three weeks.
However, he was uninterested in activities going on around him Brain damage sexuality always kept his hand inside his pyjamas to masturbate. Thereafter, he openly masturbated several times. No specific medications were given. After two weeks however, it was observed that he was masturbating less frequently, and by the end of the third week, "Brain damage sexuality" had stopped completely.
A year-old housewife and mother of 2 children was admitted with moderate head injury following a ghastly road accident. She also sustained a mid-shaft fracture of left humerus and multiple soft tissue injuries to the face and body. Glasgow Coma score was 12 on admission. Ocular examination revealed normal sized pupils which reacted normally to light.
Motor function examination revealed no deficits, and tendon reflexes were normal. The skull x-rays revealed no abnormality.
She recovered rapidly and was fully conscious Brain damage sexuality the end of the second week, but remained aphasic until the fourth week. Alteration of sexual behaviour was signalled at this time when she suddenly exposed her breasts when she had a female visitor, and started using her visitor's hands to massage them. When eventually she could verbalise, she frequently used foul language until she finally demanded to go home to fulfil her sexual urge.
No medication was given on account of her behavioural change; but following careful reprimands, she stopped exposing her breasts and her use of foul language gradually diminished "Brain damage sexuality" finally stopped.
A year-old unmarried man was admitted following head injury sustained when he was struck on the head with a blunt object during a fight. There was no loss of consciousness and he had no seizures. His social history revealed that he had been smoking marijuana regularly for the past 2 years. On examination, there was deep laceration across his forehead which extended to his right parietal area. Skull X-ray showed depressed fracture of the right frontal bone.
He was managed conservatively and clinical course was smooth; and he was discharged from hospital two weeks later. The very day he was discharged however, it was Brain damage sexuality that he went out to a pool "Brain damage sexuality" stagnant water in the street close to his home and there he undressed and masturbated. He was quickly rushed indoors by his embarrassed family members, but this however, became a regular occurrence thereafter. A year-old motorcyclist was admitted for severe head injury following a road traffic accident.