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Background: Piriformis syndrome is a neuromuscular condition characterized by hip and gluteal pain caused by abnormality of piriformis muscle. In clinical practice, this syndrome is usually misdiagnosed with other spinal disorders. There is no specific test in diagnosing piriformis syndrome, therefore by understanding the characteristics and predisposing factors, clinicians may be more aware in diagnosing this syndrome. Objective: To investigate the characteristics and predisposing factors of piriformis syndrome. Methods: A descriptive study was conducted on patients with gluteal pain in a referral hospital. Diagnosis was established by block injection on piriformis muscle and showed clinical improvement afterwards. Demographic characteristics, predisposing factors, and physical examination were analyzed. The data is collected and processed by SPSS 20.0. Results: The total of 65 patients were evaluated, with a male to female ratio 1:3. As much as 47.7% of patients were > 60 years old. Average weight was 60 kg and BMI (Body Mass Index) was within normal range (58.9%). Most subjects were housewives (55.4%) and the majority of subjects had history of microtrauma such as sitting on rigid surfaces (36.9%), walking or running long distances (18.5%), and cross-legged sitting (10.8%). Average sitting per day was approximately 5 hours. In 56.9% of subjects, exercises were conducted. There was no history of back pain in 81.5% of subjects. Conclusion: Our study showed age and housewives characteristics differ with other studies. The most predisposing factors were history of microtrauma, female, age, and normal BMI.

Background: Benign idiopathic infantile masturbation (infantile dyskinesia) or also known as gratification disorder is a rare abnormal paroxysmal movement disorder that occurs in children between 3 months and 3 years old. This disorder is characterized by self-stimulation of the genitalia and associated with unusual posturing and movements. Therefore, it could mimic as seizure.2 The diagnosis of this disorder may be perplexing and scarcely reported. Case Findings: We reported a 3 years old infant with abnormal behavior and posturing with rocking and thrusting movements accompanied by erection and clear secretion from his penis. The episodes were described as hip and knee flexion towards the abdomen, plantar flexion with flexion of the toes, extension of the elbows, clenched fists, and this behavior always occurred while lying in bed. Physical and neurological examination showed normal results. The electroencephalogram (EEG) was within normal limits hence done to exclude seizure as diagnosis. Parents were then educated and the child now does not show any previous behavior. Conclusion: Benign infantile masturbation is a harmless behavior that is scarcely reported in journals and commonly mistaken as seizure. It presents with typical clinical characteristics and commonly found in females. However, our case report showed that this disorder may also be found in male with additional characteristics such as erection and clear secretion from the penis. To date, there is no exact treatment that could alleviate the symptom other than patient education. Keywords: Gratification Disorder, Benign Infantile Masturbation.

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