RESUMEN
Introducción: El trastorno hipersexual fue propuesto y desestimado como diagnóstico, con el argumento de escasa evidencia científica y uso indebido en asuntos legales, pero fue reconocido en 2018 como desorden del comportamiento sexual compulsivo. Es una entidad clínica que aún carece de reconocimiento diagnóstico, pero constituye un importante problema de salud mental, sexual y general. Objetivo: Presentar una paciente con un desorden del comportamiento sexual compulsivo y el procedimiento terapéutico empleado. Caso clínico: Paciente femenina de 21 años de edad, con antecedentes de abuso sexual en la infancia. Es traída por la madre porque no lograba controlar sus impulsos sexuales con repetidas búsquedas compulsivas de encuentros sexuales, uso frecuente de pornografía, con malestar clínico significativo y problemas en el área social, estudiantil y otras. Conclusiones: Al diagnosticar el desorden del comportamiento sexual compulsivo, es esencial la entrevista clínica, confeccionar la historia psiquiátrica completa, alcanzar el control de la conducta sexual, las comorbilidades y obtener una mejor calidad de vida del paciente.
Introduction: The hypersexual disorder was proposed and underrated as diagnostic with the argument of scarce scientific evidence and undue use in legal matters, but recognized in 2018 as disorder of compulsive sexual behavior. It is a clinical entity, that still lacks diagnostic recognition, but it constitutes an important problem of mental, sexual and general health. Objective: To present a patient with a disorder of the compulsive sexual behavior and the procedure therapeutic used. Clinical case: 21-year-old female patient, with antecedents of sexual abuse in the childhood. The mother brings her because was not able to control their sexual impulses with repeated compulsive searches of sexual encounters, frequent use of pornography with significant clinical malfunction, and problems in social, student and other important areas. Conclusions: When diagnosing compulsive sexual behavior disorder the essential is the clinical interview, to perform a complete psychiatric history, later to reach the control of the sexual behavior, comorbidity, and to obtain a better quality of the patients' life.
RESUMEN
ABSTRACT Increased of sexual arousal (ISA) has been described in different neurological diseases. The purpose of this study was present a case series of ISA in patients with movement disorders. Method Fifteen patients with different forms of movement disorders (Parkinson’s disease, Huntington’s disease, Tourette´s syndrome, spinocerebellar ataxia type 3), were evaluated in the Movement Disorders Unit of the Federal University of Paraná. Results Among Parkinson’s disease patients there were seven cases with different forms of ISA due to dopaminergic agonist use, levodopa abuse, and deep brain stimulation (DBS). In the group with hyperkinetic disorders, two patients with Huntington’s disease, two with Tourette’s syndrome, and four with spinocerebellar ataxia type 3 presented with ISA. Conclusions ISA in this group of patients had different etiologies, predominantly related to dopaminergic treatment or DBS in Parkinson’s disease, part of the background clinical picture in Huntington’s disease and Tourette’s syndrome, and probably associated with cultural aspects in patients with spinocerebellar ataxia type 3.
RESUMO A exacerbação do impulso sexual (EIS) tem sido descrita em diversas doenças neurológicas. O objetivo deste estudo foi apresentar uma série de casos de EIS em pacientes com distúrbios do movimento. Métodos Quinze pacientes com diferentes formas de distúrbios do movimento (Doença de Parkinson, doença de Huntington, síndrome de Tourette, ataxia espinocerebellar tipo 3), foram avaliados na Unidade de Distúrbios de Movimento-Universidade Federal do Paraná. Resultados Entre os pacientes com doença de Parkinson houve sete casos com diferentes formas de EIS devido ao uso de agonista dopaminérgico, abuso de levodopa ou estimulação cerebral profunda (DBS). No grupo com distúrbios hipercinéticos, dois pacientes com doença de Huntington, dois com síndrome de Tourette, e quatro com ataxia espinocerebelar tipo 3 apresentaram EIS. Conclusões EIS nesses pacientes decorreu de diferentes etiologias, relacionadas com o tratamento dopaminérgico ou DBS na doença de Parkinson, parte do quadro clinico na doença de Huntington e síndrome de Tourette, e provavelmente relacionado com aspectos culturais em pacientes com ataxia espinocerebelar tipo 3.