Forced spousal intercourse after seizures

Abstract

Hypersexuality, a feature of Klüver-Bucy syndrome, is a rare but dramatic postictal symptom of temporal lobe epilepsy. We describe a 39-year-old patient with uncontrolled partial epilepsy who developed postictal periods of hypersexual aggression toward his wife after nocturnal convulsions. Following these seizures, he would have forced intercourse with his wife, followed by tremendous guilt and remorse when informed of his actions in the morning. Nocturnal convulsions and postictal hypersexuality resolved with a combination of lamotrigine and levetiracetam, more sleep, and stress management. The temporal features of the hypersexual behavior with respect to convulsions and the resolution of the behavior with seizure control support that aggressive hypersexuality can occur as a transient postictal behavioral change. The more intense nature of his symptoms compared with previously reported cases may reflect the occurrence of symptoms after tonic-clonic rather than partial seizures.