Sexsomnia in an Adolescent.

ABSTRACT: Sexsomnia has been reported and is well described in 115 prior cases in the literature. There have been associations with other sleep disorders serving as triggers for confusional arousals, thereby worsening sexsomnia episodes. We present a case of an adolescent boy with a history of resected and treated pineoblastoma who later developed sexsomnia marked by multiple episodes of masturbatory events per night. He had additional suspicions of obstructive sleep apnea. Polysomnography confirmed severe obstructive sleep apnea and captured multiple episodes of sexsomnia from both REM and NREM sleep. The patient also had daytime symptoms of severe anxiety and hypersomnia that required pharmacological intervention, cognitive behavioral techniques, and hypnosis. The patient showed improvement with hypnosis along with a multimodal approach to the treatment of sexsomnia.

Excessive masturbation after epilepsy surgery.

Sexual behavior changes as well as depression, anxiety, and organic mood/personality disorders have been reported in temporal lobe epilepsy (TLE) patients before and after epilepsy surgery. The authors describe a 14-year-old girl with symptoms of excessive masturbation in inappropriate places, social withdrawal, irritability, aggressive behavior, and crying spells after selective amygdalohippocampectomy for medically intractable TLE with hippocampal sclerosis. Since the family members felt extremely embarrassed, they were upset and angry with the patient which, in turn, increased her depressive symptoms. Both her excessive masturbation behavior and depressive symptoms remitted within 2 months of psychoeducative intervention and treatment with citalopram 20mg/day. Excessive masturbation is proposed to be related to the psychosocial changes due to seizure-free status after surgery as well as other possible mechanisms such as Kluver-Bucy syndrome features and neurophysiologic changes associated with the cessation of epileptic discharges. This case demonstrates that psychiatric problems and sexual changes encountered after epilepsy surgery are possibly multifactorial and in adolescence hypersexuality may be manifested as excessive masturbation behavior.

Motivos sexuales de consulta en pediatría

Objetivo:presentar la experiencia con los pacientes queconsultan por motivos sexuales a un hospital universitario pediátrico. Método: se revisan los pacientes que consultaron sobre temas sexuales al Servicio de Psiquiatría del Hospital Pediátrico Universitario de la Misericordia, en el período 1991 a 1995. Los indicadores analizados fueron: quién indujo la consulta,a qué edad, las patologías asociadas o desencadenantes, el entorno familiar, escolar y social y el rendimiento escolar. Para el seguimiento las variables fueron: persistencia del motivo de consulta sexual, rendimiento escolar, relaciones sociales, juego, nuevas consultas médicas por la misma causa a otros médicos, peso y talla para la edad. Resultados: siete pacientes consultaron por masturbación y diez por conducta femenina. El grupo de masturbación son mayores de cinco años, con motivo de consulta impreciso, bajo rendimiento escolar, padecía trastorno específico del aprendizaje, retardo mental, ansiedad, epilepsia y disfunción familiar. El grupo con conducta femenina mostró bajo rendimiento escolar, el motivo de consulta fue formulado precisamente, eran rechazados por sus compañeros de estudio. Conclusiones: estos dos motivos de consulta están relacionados con alteraciones emocionales que deben diagnosticarse. Se presenta un método de abordaje y tratamiento.