Abstracts

Rationale: Orgasm may precipitate seizures that usually begin with a certain delay (minutes or hours) following climax. Most patients are female and have both spontaneous and reflex partial seizures in the context of a localization-related epilepsy. Right hemisphere involvement is common. The dominance of the right hemisphere regarding the sexual function has been well investigated. Methods: We report the case of a 21-year-old male presented with masturbation orgasm-induced seizures, with auras of musical hallucinations. This gentleman’s electrophysiology localised his seizure focus to the left temporal lobe, making this case atypical in comparison with the majority of previous reports. Results: Seizures with sexual phenomena may arise from superior post-central gyrus, parietal parasagittal region, and frontal and mediobasal temporal lobes, especially the limbic-temporal network. Musical hallucinations represent a specific form of auditory hallucinations whereby patients experience formed music, usually unpleasant melodies. Converging data from multiple studies suggest that the superior temporal sulcus is the most common site and that activation is the most common mechanism. Interestingly, our patient had orgasm-induced seizures with auras of musical hallucinations , who experienced recognizable, pleasant familial songs. Conclusions: It was hypothesized that reaching sexual climax may trigger already sensitized neurons within the limbic-temporal network localized in associative cortices concerning the pleasant musical hallucinations. We suggest that presurgical evaluation of epileptic patients should focus on reflex seizures induced by orgasm and the detailed musical hallucinations aura description. This could provide information both on the localization and the lateralization of the epileptogenic region. Funding: None