3
12
mother was asked to take a home video recording of the
episode for further consideration of the ‘seizure type.’
Five minute-video-play of the event revealed child in
prone position having rocking movement of the pelvis,
with a piece of cloth in her hands being rubbed over the
genital area and repeated flexion of the lower limbs. She
responded to the mother’s call and could be distracted
by the mother during the recorded episode.
A diagnosis of childhood masturbation mimicking
epileptic seizures was made. Parent was counseled on
the harmless nature of the behavior and was advised on
behavior modification in form of distraction of child’s
attention when the attacks are about to occur.
the child’s willful control or is occurring excessively
and in public, open places which usually connot2es
significant emotional disturbance in the subject.
In Africa and other sexually conservative regions where
6
masturbation may be regarded as a taboo, childhood
masturbation may be associated with paren,7tal anxiety
3
and feelings of shame and embarrassment. This may
predispose the child to maltreatment, parental aggression
6
or physical abuse including spanking. Some of the
reported consequences from socio-cultural practices
include female genital mutilation/cutting, with the aim
of reducing the child’s sexual desire so as to prevent the
6
development of sexual promiscuity later in life. Other
Carbamazepine therapy was gradually withdrawn. How-
ever, the patient was lost to follow up after withdrawal
of carbamazepine therapy.
forms of family or public response to childhood mastur-
bation has not been well documented as there is sparse
literatu5re available regarding masturbatory behavior as a
whole.
Case 2
Predisposing factors to childhood masturbation are still
cont3r,8o,9versial, poorly understood and less well stud-
RG, a 3year old female, was referred from the Family
medicine Department of our Hospital, with a 2-year his-
tory of abnormal stretching of the limbs. Further inquiry
revealed that episodes occur in recumbent position, with
unusual side to side pelvic movement, grunting and fa-
cial flushing during the episodes. No impairment of con-
sciousness and child responds to, and can be distracted
temporarily during the episodes. Frequency of the epi-
sodes was 3-4 times per week. Child knows when the
episode is “about to come” and would find a place to
ied.
However, speculations as to how children learn
to masturbate have been proffered. Just as infants learn
to explore the functions of their fingers and mouth, they
2
do the same with their genitalia. They discover that
touching some areas (like the genitalia) is pleasurable
1
0
and are motivated to touch those areas more often.
Child masturbation may be viewed in the same way as
thumb-sucking or other behaviors that infants use to
5
enhance comfort. Younger children do not attach sexual
“
lean.” Parents have used various traditional medica-
thoughts to the act of masturbation but are simply1doing
1
tions and spiritual healing with no improvement. She
had normal developmental history and unremarkable
clinical examination. Investigations done before the
referral were unremarkable, including serum electro-
lytes, calcium and EEG. A video recording of the epi-
sode brought by the parents, showed the child in prone
position, with abnormal side to side pelvic movement,
repeated flexion and extension the lower limbs with the
hands stocked in between the thighs.
A diagnosis of childhood masturbation was made
following the clinical history and observation of the
video recording of the episode. Parents were counseled
about the behavior, being a normal developmental proc-
ess, and were advised on behavioral modification/
distraction of child’s attention. She was reviewed six-
weeks later, frequency of the episodes was said to have
reduced to 2-3 times per week. Some intended
what feels good, providing them with comfort. This
explanation may be reassuring to some parents who are
alarmed by the child’s behavior.
Perineal irritation was also thought as a predisposing
factor for child masturbation, but the exact relationship
is unclear. However, perineal irritation/itching may in-
5
tensify the behavior and increase its frequency. Also,
child masturbation may be associated with physical or
emotional stress in form of bo8redom or lack of stimula-
tion, as contributing factors. Masturbation has been
shown to occur more often in children who are deprived
7
in tactile stimulation. Franić et al. have demonstrated
this fact in a girl who was born nine-months after her
older sister. Her pregnancy was unwanted and she was
breastfed for a short period of time (less than a month).
The child developed infantile masturbation which disap-
peared during a four-week period in which she suffered
chicken pox. In that period, the child was more fre-
quently in contact with her mother because of treatment
with potassium permanga7nate baths and consequently
more tactically stimulated.
masturbation episodes were interrupted by distracting
child’s attention as advised. Patient was subsequently
lost to follow-up.
There is female preponderance of cases of child mastur-
bation which may justify a hypothetical conjecture that
it may be hormone related, perhaps postnatal withdrawal
Discussion
9
3
of maternal hormones. Thus, Ajlouni et al. studied sex
hormones and clinical profiles of thirteen masturbating
infants and young children where they found compara-
ble levels of all sex hormones with the control group,
except oestradiol, which was significantly lower among
the case group. However, oestradiol, being the most
important of the oestrogen hormones that stimulate
Childhood masturbation; though a normal developmen-
tal process may be of medical significance when it is
mistaken for other diagnoses including epilepsy,
movement disord,5ers or other medical conditions like
4
abdominal pain. Masturbation also becomes a psycho-
pathological disorder if it becomes a compulsion beyond