Hypersexual Behavior and Multiple Sclerosis
DOI:
https://doi.org/10.34024/rnc.2025.v33.19265Keywords:
Autopsy, Exhibitionism, Hypersexuality, Multiple Sclerosis, NeuroimagingAbstract
Introduction. Multiple sclerosis (MS) is associated with a wide range of behavioral disorders. Although sexual dysfunction is common, hypersexual behavior is rarely reported and has often been associated with psychiatric comorbidities. Objective. To perform a systematic review of 20th and 21st-century reports of hypersexual behavior in MS. Method. A systematic review of 20th and 21st-century case reports of hypersexual behavior in MS was performed. References from the pre-neuroimaging era and more recent neuroimaging literature were analyzed. The initial PubMed search included the words hypersexuality, hyperlibidinism, paraphilias, sexual disorders, and multiple sclerosis. Results. Seven cases reported in the pre-neuroimaging literature and ten in the neuroimaging era were found, and three distinct pathological categories were identified according to the predominance of symptoms: primary increase in libido, disinhibition, and generalized disease. Analysis of lesions from neuroimaging studies and autopsy revealed frontal lobe, periventricular, and generalized disease in the majority of cases. Cases of disseminated disease showed abrupt change in sexual behavior and younger age of onset. Conclusion. In summary, hypersexual behavior in patients with MS can be categorized into groups depending on symptoms and anatomical location of plaques. This literature review revealed frequent cases with severe neurobehavioral manifestations. The mild to moderate spectrum of behavioral changes may be underreported due to social stigma.
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Copyright (c) 2025 David Nunes de Lima Junior, Emanuele Ribeiro Ramos, Erick Leite Maia de Messias, Florian P. Thomas, Antonio Miguel Furtado Leitão, Lia Lira Olivier Sanders, Francisco de Assis Aquino Gondim
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Accepted 2025-01-23
Published 2025-02-14
