Persistent Genital Arousal Disorder Following Right Selective Hippocampectomy

Abstract

Persistent Genital Arousal Disorder (PGAD) is an unprovoked and spontaneous sensation of persistent genital arousal that cannot be relieved with one or several orgasms. At present, little is known about the etiology of this condition. We describe the case of a 37-year-old single woman with typical PGAD symptoms. She was followed up for drug-resistant temporal lobe epilepsy for 17 years until right hippocampectomy due to right mesial temporal sclerosis. Seven years after the surgery, she developed obsessive compulsive symptoms and excessive sexual behavior. These persistent feelings of sexual excitation were not characteristic of her preoperative epileptic seizures. No epileptic abnormality was seen in her last EEG, and she did not experience seizures after the surgery. She was still on 900 mg/day oxcarbazepine. Her symptoms were completely resolved with psychotherapy as well as 2 mg/day risperidon and 30 mg/day paroxetine treatment. Our aim was to discuss and draw attention to the rare condition of PGAD, which developed seven years after epilepsy surgery in our case. Successful treatment requires a multidisciplinary approach and consideration of all reversible causes as well as cognitive therapy.