Transient Acute Neurologic Sequelae of Sexual Activity: Headache and Amnesia

Abstract

Introduction Sexual activity may on occasion be complicated by neurologic syndromes of headache and amnesia. These syndromes may be alarming not only to patients but also to medical practitioners unfamiliar with them, initiating inappropriate investigations or advice. Aims To review the clinical features, differential diagnosis, investigation, pathophysiology, and treatment of primary headache associated with sexual activity and of transient global amnesia precipitated by sexual activity. Methods Selective literature review. Conclusion Transient headache and amnesia associated with sexual activity are generally benign, self-limited syndromes of presumed vascular origin. The most important differential diagnosis in both instances is subarachnoid hemorrhage, but this may be readily excluded on the basis of clinical and investigational findings. Reassurance, based on clear diagnosis, is the most important treatment.

Sexual activity-related emergency department admissions: eleven years of experience at a Swiss university hospital

“…As in our study, Larner found that men were more frequently affected 7 17. The sudden and severe onset of orgasmic headache means that arterial dissection and subarachnoid haemorrhage should always be excluded 7 17 21. The latter was the second most common sexually triggered neurological emergency in our study.…”

“…The actual incidence of orgasmic headache is unknown 17 20. As in our study, Larner found that men were more frequently affected 7 17.…”

“…The patients in this group were older than other groups of emergency patients in the present study, and were marked older than in studies reported elsewhere 17 18. Our study also confirmed that patients with postcoital headache are generally younger than patients with sexually triggered subarachoid haemorrhage 4 17 18.…”

“…The patients in this group were older than other groups of emergency patients in the present study, and were marked older than in studies reported elsewhere 17 18. Our study also confirmed that patients with postcoital headache are generally younger than patients with sexually triggered subarachoid haemorrhage 4 17 18. According to a review by Reynolds et al 4 on sexual intercourse-related rupture of cerebral aneurysm, the high rate in the over-50s might be explained by the increased prevalence of hypertension, which is associated with increased aneurysm wall tension and a consequent increased risk of rupture.…”

“…The actual incidence of orgasmic headache is unknown 17 20. As in our study, Larner found that men were more frequently affected 7 17. The sudden and severe onset of orgasmic headache means that arterial dissection and subarachnoid haemorrhage should always be excluded 7 17 21.…”