Focal paraneoplastic limbic encephalitis presenting as orgasmic epilepsy

Fadul, Camilo E.; Stommel, Elijah W.; Dragnev, K.; Eskey, Clifford J.; Dalmau, Josep

doi:10.1007/s11060-004-2242-9

Cited by 40 publications

(26 citation statements)

References 19 publications

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“…Our assumption is also consistent with Komisaruk et al's (2004) recent findings demonstrating an activation of the insula during online solo cervical-stimulation induced orgasm in spinalcord damaged women. In line with this, recent fMRI findings in men and EEG data in epileptic patients also showed that an orgasm results from a spread of neural activation within multiple brain areas, of which the insula might play a particular role Calleja et al, 1988;Chuang et al, 2004;Currier et al, 1971;Fadul et al, 2005;Freemon and Nevis, 1969;Janszky et al, 2002Janszky et al, , 2004McKenna, 2002;Ortigue and Bianchi-Demicheli, 2006;Shelley and Trimble, 2004). Along these lines, our results thus suggest that the insula serves as an integration cortex for multimodal and conceptual convergence of information that may play a role in second-order representations of bodily states (such as those involved in subjective quality ratings of orgasm) based on, for instance, recollections of sexual sensations, sexual fantasies and knowledge about sexual rewards or costs (sexual memory ;Spiering, 2004;Spiering et al, 2003).…”

Section: Discussionsupporting

confidence: 59%

Correlation between insula activation and self-reported quality of orgasm in women

2007

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Current multidimensional models of women's sexual function acknowledge the implicit impact of psychosocial factors on women's sexual function. Interaction between human sexual function and intensity of love has been also assumed, even if love is not an absolute condition. Yet, whereas great insights have been made in understanding the central mechanisms of the peripheral manifestations of women's sexual response, including orgasm, the cerebral correlates sustaining the interaction between women's sexual satisfaction and the unconscious role of the partner in this interpersonal experience remain unknown.Using functional imaging, we assessed brain activity elicited when 29 healthy female volunteers were unconsciously exposed to the subliminal presentation of their significant partner's name (a task known to elicit a partner-related neural network) and correlated it with individual scores obtained from different sexual dimensions: selfreported partnered orgasm quality (ease, satisfaction, frequency), love intensity and emotional closeness with that partner.Behavioral results identified a correlation between love and selfreported partnered orgasm quality. The more women were in love/ emotionally close to their partner, the more they tended to report being satisfied with the quality of their partnered orgasm. However, no relationship was found between intensity of love and partnered orgasm frequency.Neuroimaging data expanded these behavioral results by demonstrating the involvement of a specific left-lateralized insula focus of neural activity correlating with orgasm scores, irrespective of dimension (frequency, ease, satisfaction). In contrast, intensity of being in love was correlated with a network involving the angular gyrus.These findings strongly suggest that intimate and sexual relationships are sustained by partly different mechanisms, even if they share some emotional-related mechanisms. The critical correlation between self-reports of orgasm quality and activation of the left anterior insula, a part of the partner-related neural network known to play a pivotal role in somatic processes, suggests the importance of somatic information in the integration of sexual experience. On the other hand, the correlation between activation of the angular gyrus and love intensity reinforces the assumption that the representation of love calls for higher order cognitive levels, such as those related to the generation of abstract concepts. By highlighting the specific role of the anterior insula in the way women integrate components of physical satisfaction in the context of an intimate relationship with a partner, the current findings take a step in the understanding of a woman's sexual pleasure.

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Section: Discussionsupporting

confidence: 59%

Correlation between insula activation and self-reported quality of orgasm in women

2007

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“…Although orgasm is not a pathological symptom of human sexual response, it can be assumed that epileptic orgasmic aura are caused by electric discharges at the same brain regions, which produce the physiological orgasm in healthy subjects. This assumption is reinforced by the fact that most of the present patients attributed their orgasmic aura to a feeling very similar to one which they experienced during sexual intercourse or masturbation (Bancaud et al, 1970;Calleja et al, 1988;Chuang et al, 2004;Crevenna et al, 2000;Erickson, 1945;Fadul et al, 2005;Freemon & Nevis, 1969;Gautier-Smith, 1980;Heath, 1972;Janszky et al, 2004;Janszky et al, 2002;Reading & Will, 1997;Remillard et al, 1983;Ruff, 1980;Torelli & Bosna, 1958).…”

Section: Neurological Case Reportsmentioning

confidence: 56%

“…For a better understanding of this phenomenon, we focused our review on female patients who experienced spontaneous orgasms (Bancaud et al, 1970;Calleja, Carpizo, & Berciano, 1988;Chuang, Lin, Lui, Chen, & Chang, 2004;Crevenna, Homann, Feichtinger, Ott, & Korner, 2000;Currier, Little, Suess, & Andy, 1971;Erickson, 1945;Fadul, Stommel, Dragnev, Eskey, & Dalmau, 2005;Freemon & Nevis, 1969;GautierSmith, 1980;Heath, 1972;Janszky et al, 2002Janszky et al, , 2004Reading & Will, 1997;Remillard et al, 1983;Ruff, 1980;Torelli & Bosna, 1958; Table 1). This approach allowed us to find 20 patients, aged 20-57 years, who experienced spontaneous orgasms subsequent to the recruitment of specific brain areas.…”

Section: Neurological Case Reportsmentioning

confidence: 99%

Toward an understanding of the cerebral substrates of woman's orgasm

Bianchi‐Demicheli

Ortigue

2007

Neuropsychologia

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The way women experience orgasm is of interest to scientists, clinicians, and laypeople. Whereas the origin and the function of a woman's orgasm remains controversial, the current models of sexual function acknowledge a combined role of central (spinal and cerebral) and peripheral processes during orgasm experience. At the central level, although it is accepted that the spinal cord drives orgasm, the cerebral involvement and cognitive representation of a woman's orgasm has not been extensively investigated. Important gaps in our knowledge remain. Recently, the astonishing advances of neuroimaging techniques applied in parallel with a neuropsychological approach allowed the unravelling of specific functional neuroanatomy of a woman's orgasm. Here, clinical and experimental findings on the cortico-subcortical pathway of a woman's orgasm are reviewed and compared with the neural basis of a man's orgasm. By defining the specific brain areas that sustain the assumed higherorder representation of a woman's orgasm, this review provides a foundation for future studies. The next challenge of functional imaging and neuropsychological studies is to understand the hierarchical interactions between these multiple cortical areas, not only with a correlation analysis but also with high spatio-temporal resolution techniques demonstrating the causal necessity, the temporal time course and the direction of the causality. Further studies using a multi-disciplinary approach are needed to identify the spatio-temporal dynamic of a woman's orgasm, its dysfunctions and possible new treatments.

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“…These antibodies were characterized by the staining of the nuclei of Purkinje and granular cells of the cerebellar neurons and of the myenteric plexus but negative reactions of anti-nuclear antibodies on the liver sections. The specificity of this reaction was further confirmed by Western immunoblotting All cases but one (''orgasmic epilepsy'' [7]) had clinically documented epileptic phenotypes: left facial twitching [3,4] right facial twitching, [5] right arm jerking, [6] left hand (case 1), [3] and right face and hand (case 2). on Purkinje and granular cell extracts of cerebellum, demonstrating a 35-40 kD band.…”

Section: Case Reportmentioning

confidence: 82%