Gratification phenomena in children: a report of nineteen children and review of the literature
Keywords:Epilepsy, Gratification phenomena, Infantile masturbation, Paroxysmal events, Video recording
Background: Gratification phenomena (GP) are self-stimulatory behavior and also called as infantile masturbation. This phenomenon is especially seen in early childhood. GP is often misdiagnosed as epilepsy, dystonia, urinary tract infection or infantile colic resulting in numerous investigations and treatment because of variable behaviors during this event.
Methods: This study aimed to describe the features of GP, so that clinicians can better recognize this condition, to prevent unnecessary evaluations, and provide appropriate guidance to parents. This study is a prospective observational study, conducted in patients with GP between March 2019 and November 2020. GP was diagnosed on the basis of history, eyewitness account and video recording of the event
Results: During the study period, 19 children were diagnosed with GP. Out of 19, 17(89.4%) children were females. The mean age at onset was 17months (range 5-36months). The mean age at diagnosis was 20 months (range 8-47months). The mean frequency of events was 4/day (range 1-12/day). A typical GP was seen in 12 of 19 (63.15%) children. At the time of referral, 31% of children were diagnosed with epilepsy and 26% of children were diagnosed with infantile colic. During follow up period, GP was subsided within 4-12 months after the initial visit.
Conclusions: A GP, otherwise called infantile masturbation, is an important consideration in the differential diagnosis of epilepsy and other paroxysmal events in early childhood. A detailed history and video recording of events often prevents unnecessary investigations and treatments.
Nechay A, Ross LM, Stephenson JB, O’Regan M. Gratification disorder (“infantile masturbation”): A review. Arch Dis Child. 2004;89(03):225-6.
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(06):1427-32.
Jan MM, Al Banji MH, Fallatah BA. Long-termoutcome of infantile gratification phenomena. Can J Neurol Sci. 2013;40(03):416-9.
Fleisher DR, Morrison A. Masturbation mimicking abdominal pain or seizures in young girls. J Pediatr. 1990;116:810-4.
Mink JW, Neil JJ. Masturbation mimicking paroxysmal dystonia or dyskinesia in a young girl. Mov Disord. 1995;10:518-20.
Bakwin H. Erotic feelings in infants and young children. Am J Dis Child. 1973;126:52-4.
Omran MS, Ghofrani M, Juibary AG. Infantile masturbation and paroxysmal disorders. Indian J Pediatr. 2008;75(02):183-5.
Koul R, Futaisi AAl, Mani R, Abdelrahim R, Aladi A. Gratification phenomena in infancy: a report of twenty-nine children. J Pediatr Neurol. 2020;18(03):141-3.
Bradley SJ. Childhood female masturbation. Can Med Assoc J. 1985;132:1165‑6.
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(04):417-9.
Satapathy AK, Das L, Biswal B. Gratification behaviour: a seizure mimicker in children. Sri Lanka J Child Health. 2000;49(1):75-6.
Livingston S, Berman W, Pauli LL. Masturbation simulating epilepsy. Clin Pediatr. 1975;14:232-4.
Leung AK, Robson WL. Childhood masturbation. Clin Pediatr. 1993;32:238-41.
Berridge KC, Kringelbach ML. Pleasure systems in the brain. Neuron. 2015;86(03):646-64.
Unal F. The clinical outcome of childhood masturbation. Turk J Pediatr. 2000;42(4):304-7.
Bilgic A, Gurkan K, Turkoglu S. Excessive masturbation and hypersexual behavior associated with methylphenidate. J Am Acad Child Adolesc Psychiatry. 2007;46(7):789-90.
Ogasawara M, Takeda M. Attention deficit disorder without hyperactivity, (excessive) masturbation, nail biting/onchophagia, nose picking/rhinotillexomania, finger sucking. Ryoikibetsu Shokogun Shirizu. 2003;(40):92-4.