Hypersexuality and hemiballism due to subthalamic infarction

Neuropsychiatry Neuropsychol Behav Neurol. 2000 Jul;13(3):220-9.


Objective: A 70-year-old right-handed man presented with a subthalamic infarction followed by persistent hypersexuality and hemiballism. A lacunar infarction 1 cm in diameter was observed on magnetic resonance imaging. We hypothesized that metabolic abnormalities would be detected in cortical areas related to his neurobehavioral symptoms.

Background: Statistical validation of the regional metabolic changes that may relate to neuropsychiatric symptoms has been elusive. Relating metabolic changes to neuropsychiatric symptoms is especially important in unique neurobehavioral cases.

Method: Quantitative fluorodeoxyglucose positron emission tomography was obtained for a single-subject comparison with scans from 60 healthy subjects.

Results: Substantial glucose hypometabolism (p <0.001, uncorrected; [df = 56]) was identified in the subthalamic nucleus at the site of the lacunar infarction. Hypermetabolism (p <0.01) was identified within the basal forebrain and temporal lobes, anterior cingulate and medial prefrontal cortices (areas previously associated with hypersexuality), and striatum (p <0.001) ipsilateral to the stroke (areas known to relate to hemiballism).

Conclusions: Single-subject statistical parametric mapping may improve our understanding of unique neurobehavioral cases.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Brain / blood supply
  • Brain / metabolism
  • Brain / pathology*
  • Case-Control Studies
  • Cerebral Infarction / complications*
  • Cerebral Infarction / metabolism
  • Cerebral Infarction / pathology
  • Dominance, Cerebral
  • Dyskinesias / etiology*
  • Fluorodeoxyglucose F18
  • Humans
  • Libido*
  • Magnetic Resonance Imaging
  • Male
  • Radiopharmaceuticals
  • Subthalamic Nucleus / metabolism
  • Subthalamic Nucleus / pathology*
  • Tomography, Emission-Computed*


  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18