Self-stimulation in an adult misdiagnosed with focal epilepsy

Self-stimulation is a normal part of development and a common behaviour in children before puberty, but very rare in adults. The stereotyped semiology can sometimes raise the suspicion of epilepsy. We present a 30-year-old patient who came to our epilepsy monitoring unit for differential diagnosis of nocturnal episodes, interpreted elsewhere as hypermotor status epilepticus associated with a known diagnosis of focal epilepsy and septo-optic dysplasia. The recorded events during video-EEG were consistent with psychogenic self-stimulating behaviour, which improved with psychotherapy. Disturbed sexual development with hypopituitarism and poor eyesight, androgen replacement therapy, alongside a protective environment provided by her parents, were the identified predisposing factors for this uncommon entity in an adult. [Published with video sequence].