Introduction. Child molestation or other pedophilic behavior may result as a consequence of a brain disorder.
Aim. To characterize the mechanisms of pedophilic behavior associated with neurological diseases.
Methods. We report eight patients with pedophilic behavior as a manifestation of their brain disorder and review the literature.
Main Outcome Measures. The sexual, neuropsychiatric, and neurological aspects of a series of patients.
Results. All eight developed sexual behavior toward prepubescent children in mid- to late-life coincident with the development of a neurological disorder. Five had limited insight, anxiety, or concern for their behavior and tended to have frontal lobe executive deficits. Most of this group had frontally predominant disorders. Two others retained insight and concern in the context of marked hypersexuality. This second group had treated Parkinson's disease and resembled reports of pedophilic behavior from subcortical lesions. The further presence of right temporal lobe-amygdala involvement may have predisposed to specific sexual preoccupation in some patients.
Conclusions. Brain disorders may release a predisposition to sexual attraction for children through disinhibition with frontal disease, sexual preoccupation with right temporal disease, or hypersexuality with subcortical disease in non-motor basal ganglia, hypothalamus, or septal nuclei. Differentiating these mechanisms of pedophilic behavior from brain disease could facilitate targeted interventions. Mendez M and Shapira JS. Pedophilic behavior from brain disease. J Sex Med 2011;8:1092–1100.