ABSTRACT

This work synthesises several previous lines of research. Sexual abnormality in temporal-lobe epilepsy, usually manifesting as a hyposexuality, was first identified in the 1950s. Cases of hypersexuality also were reported. During the following two decades, many instances of temporal-lobe epilepsy or temporal-lobe EEG spiking in cases of abnormal sexual outlet were documented. The most common of these sexual abnormalities was fetishism (including transvestic fetishism). Conversely, a study of epileptics showed an increased incidence of fetishism and other abnormalities of sexual outlet in cases in which the epilepsy was localised to the temporal lobe. More recently, an anticonvulsant effect of serotonin, no doubt a consequence of its neuromodulatory action, has been reported. And just within the past few years there have been several case reports of serotonin selective reuptake inhibitors as successful therapies in true, ego-dystonic fetishism. This proposal encompasses a test of the association of fetishism and epileptiform EEG, a controlled evaluation of the behavioural effect of the serotonin selective reuptake inhibitor fluoxetine in fetishists, and a controlled evaluation of any concomitant EEG effect of fluoxetine in fetishists.

Specific Aims