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Right orbitofrontal tumor with pedophilia symptom and constructional apraxia sign
Jeffrey M Burns1, Russell H Swerdlow
1Department of Neurology, University of Virginia Health System, 1 Hospital Dr, Charlottesville, VA 22908, USA.
Background:
Orbitofrontal abnormalities are associated with poor impulse control, altered sexual behavior, and sociopathy.
Objective:
To describe a patient with acquired pedophilia and a right orbitofrontal tumor who was unable to inhibit sexual urges despite preserved moral knowledge.
Design:
Case report.
Results:
The patient displayed impulsive sexual behavior with pedophilia, marked constructional apraxia, and agraphia. The behavioral symptoms and constructional deficits, including agraphia, resolved following tumor resection.
Conclusions:
For patients with acquired sociopathy and paraphilia, an orbitofrontal localization requires consideration. This case further illustrates that constructional apraxia can arise from right prefrontal lobe dysfunction. Agraphia may represent a manifestation of constructional apraxia in the absence of aphasia and ideomotor apraxia.