Hypersexuality following bilateral thalamic infarction: case report

hypersexuality is a rare but well recognized condition following brain injury. it has been described secondarily to dysfunction in the hypothalamus, the temporal and frontal lobes. we report a 63 year-old man that developed neuropsychological disturbances with hypersexuality as a prominent feature, disinhibition and moderate memory loss, hypersomnia and irritability after a bilateral paramedian thalamic infarction. a spect showed frontal hypoperfusion. we believe that these findings are expression of frontal-subcortical circuits dysfunction, particularly the orbitofrontal circuit, secondary to dorso medial thalamic infarction which probably plays a role in the determination of human sexual behavior. this case favors a thalamic modulation of frontal function.