Case 19 - Hypersexuality in a 69-year-old man  pp. 139-147

Hypersexuality in a 69-year-old man

By Oscar L. Lopez and James T. Becker

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Clinical history – main complaint

A 69-year-old man who developed a Kluver–Bucy syndrome (KBS) (i.e., hypersexuality, bulimia, hyperorality, placidity), pseudobulbar affect, depression, and psychosis after multiple cerebral ischemic lesions. At age 68, he experienced a left side hemiparesis of acute onset secondary to a pontine ischemic lesion. He was left with a mild left side weakness, instability with tendency to fall, and mild pseudobulbar affect; he had a tendency to cry in the absence of depression or external factors.

One year later, he developed headaches, dizziness (described as disequilibrium), and increased left side weakness. He became apathetic, socially withdrawn, docile, and had episodes of rage and verbal and physical violence. He tended to eat voraciously, stuffing food in his mouth. He compulsively put his fingers in his mouth and bit his cane, and he spent hours masturbating, regardless of the presence of family members. He also developed urinary incontinence. Nevertheless, he was able to read the newspaper and followed programs on TV. He gradually developed symptoms of major depression.

General history

High school graduate with history of hypertension and coronary artery disease. He lives with his wife.

Family history

Father died at age 70 and mother at age 78 of heart disease. No history of dementia was reported in his family.

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