Apotemnophilia

Apotemnophilia is a neurological disorder characterized by the intense and long-standing desire for amputation of a specific limb, or a need to become paralyzed, blind or deaf. Another more recent term for it is body integrity identity disorder (BIID) in which otherwise sane and rational individuals express a strong and specific desire for the amputation of a healthy limb or limbs. Apotemnophilia has features in common with somatoparaphrenia. Some apotemnophiles seek surgeons to perform an amputation or purposefully injure a limb in order to force emergency medical amputation.

A separate definition of apotemnophilia is erotic interest in being or looking like an amputee. This separate definition should not be confused with acrotomophilia, which is the erotic interest in people who are amputees. Apotemnophilia was first described in a 1977 article by psychologists Gregg Furth and John Money: "Apotemnophilia: two cases of self-demand amputation as paraphilia." More recently (2008), V.S. Ramachandran, David Brang and Paul D. McGeoch have proposed that it is a neurological disorder caused by an incomplete body image map in the right parietal lobe.

The study carried out David Brang, Paul McGeoch and V.S. Ramachandran in 2008 was only able to work with two subjects. In 2011 Paul McGeoch et al. published the results of an experiment in which they were able to obtain MEG images of the parietal lobes for four research subjects, three of whom desired amputation. McGeoch and his co-researchers concluded that the images suggest "that inadequate activation of the right superior parietal lobe (SPL) leads to the unnatural situation in which the sufferers can feel the limb in question being touched without it actually incorporating into their body image, with a resulting desire for amputation." This reported abnormality in the function of the right parietal lobe was subsequently supported by an 2013 anatomical study by Peter Brugger's group, which found a reduced cortical thickness of this part of the brain in people who desired an amputation when compared to controls.

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