Infantile Masturbation in a Nigerian Child: A Case Report of a Rare Seizure Mimic
Keywords:Africa, Early Childhood Masturbation, Gratification Behaviour, Gratification disorer, Infantile Gratification, Seizure
Infantile masturbation is a benign, paroxysmal, non-epileptic condition with stereotypic stiffening of the body/limbs, copulatory-like thrusting/rocking of the pelvis and somatosensory symptoms. It usually occurs without direct genital stimulation thus, making it easily misdiagnosed as epilepsy. A 12-month-old girl presented with a one-month history of 'jerking' with no fever or altered consciousness. The event usually stopped with distraction. The frequency and duration of events worsened progressively. Epilepsy was suspected initially but a subsequent review of a video recording showed a conscious female child with intermittent rhythmic rocking/thrusting of the pelvis while lying prone, making epilepsy unlikely. Infantile masturbation was diagnosed and the parents were counselled on behavioural therapy (distractions). The frequency and duration of the events progressively declined until complete resolution by six years of age. The characteristics of the events remained similar overtime except for occasional tucking of her clothes into her vagina at age five years. This report is accompanied by a review of the relevant literature on infantile masturbation.
Wilkinson B, John RM. Understanding Masturbation in the Pediatric Patient. J Pediatr Heal Care 2018; 32: 639–643. https://doi.org/10.1016/j.pedhc.2018.05.001.
Tatlı B, Güler S. Non-epileptic paroxysmal events in childhood. Turkish Arch Pediatr 2017; 52: 59–65. https://doi.org/10.5152/TurkPediatriArs.2017.4588.
Negash S, Bahiretibeb Y. A rocking child: infantile masturbation in a five-year-old girl. Ethiop Med J 2020; 58: 271–274.
Pandurangi A, Pandurangi S, Mangalwedhe S, Mahadevaiah M. Gratification behaviour in a young child: Course and management. J Sci Soc 2016; 43: 48. https://doi.org/10.4103/0974-5009.175464.
Johnston M V. Conditions that mimic seizures. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, editors. Nelson Textbook of Pediatrics. Elsevier Inc.; 2007. p. 2476–2478.
Yang ML, Fullwood E, Goldstein J, Mink JW. Masturbation in Infancy and Early Childhood Presenting as a Movement Disorder: 12 Cases and a Review of the Literature. Pediatrics 2005; 116: 1427–1432. https://doi.org/10.1542/peds.2005-0532.
Jan MM, Al Banji MH, Fallatah BA. Long-term outcome of infantile gratification phenomena. Can J Neurol Sci 2013; 40: 416–419. https://doi.org/10.1017/s0317167100014396.
Otaigbe BE. Infantile masturbation in an African female: Is this a justification for female genital cutting? World J Pediatr 2008; 4: 148–151. https://doi.org/10.1007/s12519-008-0030-x.
Ibrahim A, Raymond B. Gratification disorder mimicking childhood epilepsy in an 18-month-old Nigerian girl: A case report and review of the literature. Indian J Psychol Med 2013; 35: 417. https://doi.org/10.4103/0253-7176.122247.
Othman SA. Self-gratification in Sudanese children: indisputable but implausible. Case Reports and Literature Review. Merit Res J Med Med Sci 2015; 3: 459–461.
Riley DS, Barber MS, Kienle GS, Aronson JK, von Schoen-Angerer T, Tugwell P, et al. CARE guidelines for case reports: explanation and elaboration document. J Clin Epidemiol 2017; 89: 218–235. https://doi.org/10.1016/j.jclinepi.2017.04.026.
Ajlouni HK, Daoud AS, Ajlouni SF, Ajlouni KM. Infantile and early childhood masturbation: Sex hormones and clinical profile. Ann Saudi Med 2010; 30: 471–474. https://doi.org/10.4103/0256-4947.72271.
Mikati MA, Obeid MM. Conditions That Mimic Seizures. In: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, et al., (Editors). Nelson Textbook of Pediatrics. Elsevier; 2020. p. 12178–12201.
Omran MS, Ghofrani M, Juibary AG. Infantile masturbation and paroxysmal disorders. Artic Indian J Pediatr · 2008; 75: 183–185. https://doi.org/10.1007/s12098-008-0028-3.
Gündüz S, Uşak E, Yüksel ÇN. Early Childhood Masturbation. Med J Islam World Acad Sci 2015; 23: 59–62. https://doi.org/10.12816/0014500.
Fernández RV, Cajal CLR. In-utero gratification behaviour in male fetus. Prenat Diagn 2016; 36: 985–986. http://doi.wiley.com/10.1002/pd.4923.
Phillips DF, Seshia SS. Gratification, masturbation or paroxysmal hyperkinetic motor syndrome of infancy? Can J Neurol Sci 2013; 40: 278–279. https://doi.org/10.1017/S0317167100014189.
Bale Jr JF, Bonkowsky JL, Filloux FM, Hedlund GL, Nielsen DM, Larsen PD. A Color Handbook of Pediatric Neurology. London, UK: Manson Publishing Ltd; 2012.
Nechay A, Ross LM, Stephenson JBP, O’Regan M. Gratification disorder (“infantile masturbation”): A review. Arch Dis Child 2004; 89: 225–226. https://doi.org/10.1136/adc.2003.032102.
Doust ZK, Shariat M, Zabandan N, Tabrizi A, Tehrani F. Diagnostic value of the urine mucus test in childhood masturbation among children below 12 years of age: A cross-sectional study from Iran. Iran J Med Sci 2016; 41: 283–287.
Rossi P, Rouanet L. Gender Preferences in Africa: A Comparative Analysis of Fertility Choices. World Dev 2015; 72: 326–345. http://dx.doi.org/10.1016/j.worlddev.2015.03.010.
Bakwin H. Erotic feelings in infants and young children. Am J Dis Child 1973; 125: 52–54.
Satapathy AK, Das L, Biswal B. Gratification behaviour: A seizure mimicker in children. Sri Lanka J Child Health 2020; 49: 75–76. http://dx.doi.org/10.4038/sljch.v49i1.8903.
Stainman RS, Kossoff EH. Seizure mimics in children: An age-based approach. Curr Probl Pediatr Adolesc Health Care 2020; 000: 100894. https://doi.org/10.1016/j.cppeds.2020.100894.
Koul R, Al-Futaisi A, Mani R, Abdelrahim R, Al-Adi A. Gratification Phenomena in Infancy: A Report of Twenty-Nine Children. J Pediatr Neurol 2020; 18: 141–143. https://doi.org/10.1055/s-0039-1679902.
Babu TA. Infantile masturbation: Pitfalls in diagnosis and possible solutions. Indian J Psychiatry 2012; 54: 393. https://www.indianjpsychiatry.org/text.asp?2012/54/4/393/104847.
Sertdemir M, Bilgiç A. Diagnostic Video of Infantile Masturbation. J Pediatr Neurol 2019; 17: 123–124. https://doi.org/10.1055/s-0038-1641728.
Nagy E, Hollody K, Nagy E. Paroxysmal non-epileptic events in infancy: five cases with typical features. Epileptic Disord 2019; 21: 458–462.
Kurian MA, Dale RC. Movement disorders presenting in childhood. Contin (Minneap Minn) 2016; 22: 1159–1185.
Franić T, Franić IU. Infantile masturbation - Exclusion of severe diagnosis does not exclude parental distress - Case report. Psychiatr Danub 2011; 23: 398–399.
Singhapakdi K, Maertens P. Gratification Disorder as an Early Marker of Rett Syndrome: Two Pediatric Case Reports. J Pediatr Neurol 2020. https://doi.org/10.1055/s-0040-1716546.
The articles and other materials published in the Annals of Health Research are protected by the Nigerian Copyright laws. The journal owns the copyright over every article, scientific and intellectual materials published in it. However, the journal grants all authors, users and researchers access to the materials published in the journal with the permission to copy, use and distribute the materials contained therein only for academic, scientific and non-commercial purposes.