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Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
Question Title: pallidotomyForum: Neurology Forum
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I am a neuropsychologist and I recently saw a patient who is 2 years s/p right pallidotomy. He reported a change (increase) in his sexual functioning following this procedure. He describes this change as a new onset "sexual addiction" which is causing him considerable difficulty in his marriage as he reports his wife is unable to satisfy his increased desire and he is forced to seek sex outside his marriage. My question is: Are changes in sexual functioning ever reported following pallidotomy? It seems plausible given that the surgery involves anatomy in the area of the limbic system. = This is unusual. We have not encountered this. But there are a few possibly related phenomena which may be relevant. Some patients who have undergone pallidotomies (unilateral or bilateral) have experienced transient (less than 3 months) increase in food appetite. One could suppose this might be related to edema impinging on related centers in the hypothalamus. Some patients who have been taking dopamine agonists (reported with Permax, but Mirapex and Requip are too new to really know yet) have become hypersexual. I believe some patients with temporal lobe epilepsy have been reported to be hypersexual. Obviously, there is the Kluver Bucy syndrome related to bilateral amygdala damage, but it's hard to postulate how both amygdalae could have been damaged in a unilateral pallidotomy. I hope this helps. CCF MD mdf.
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