FUTURE WORK

Since EEG evidence is what has been cited in the past, EEG is the logical technique with which to begin evaluating the case for a link between abnormal temporal-lobe activity and paraphilias. However, it is certainly not the be-all and end-all. It has a low yield--even in independently identified cases of epilepsy in which activation procedures are employed, EEG spikes are detected in only about half of the patients. A functional imaging study of paraphiliacs would be an interesting complement to EEG study. In addition, since serotonin is implicated in the paraphilias, it would be interesting to measure platelet serotonin uptake. Current reports suggest that this is elevated in OCD patients. Finally, since the paraphilias can be viewed as disorders of impulse control, a trial of carbamazepine is warranted. Elphick [1989] reports that carbamazepine therapy is effective against symptoms of episodic dyscontrol, most notably in bipolar and schizoaffective disorders.

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