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.

Involuntary masturbation and hemiballismus after bilateral anterior cerebral artery infarction.

Ischemia of the areas supplied by the anterior cerebral artery is relatively uncommon. In addition, combined hemiballismus and masturbation have rarely been reported in patients with cerebrovascular disease. We describe herein a 62-year-old right-handed man simultaneously exhibiting right side hemiballismus and involuntary masturbation with the left hand after bilateral infarction of the anterior cerebral artery territory. Right side hemiballismus was related to the disruption of afferent fibers from the left frontal lobe to the left subthalamic nucleus. Involuntary masturbation using the left hand was exclusively linked to a callosal type of alien hand syndrome secondary to infarction of the right side of the anterior corpus callosum. After 2 weeks, these abnormal behaviours were completely extinguished. This report stresses the wide diversity of clinical manifestations observed after infarction of the anterior cerebral artery territory.

Compulsive masturbation in infantile autism treated by mirtazapine.

This case report describes a child with a severe autistic syndrome worsened by hypersexual behavior consisting of compulsive masturbatory activity. Selective serotonin reuptake inhibitors have been reported to be beneficial in reducing hypersexual behaviors. A treatment with mirtazapine improved the entire clinical autistic picture with the disappearance of masturbation. This result suggests that selective serotonin reuptake inhibitors could be useful and promising tools in the treatment of hypersexual behaviors in children with autistic disorders. Moreover, the general, and in some ways unexpected, improvement of the social interaction, communication, and imagination, the dramatic reduction of aloof mannerisms, stereotypes, aggressiveness, and inappropriate emotional response to frustrations, as well as the first appearance of the pragmatic use of language and a strong impetus to emotional development disclosed a new spectrum of possible applications of these drugs, and mirtazapine in particular, suggesting the need for new and more extensive studies on the pharmacotherapy of autism.

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.

Genetic and environmental influences on problematic masturbatory behavior in children: a study of same-sex twins.

Child sexual behavior problems, such as excessive or public masturbation, are often judged to result from environmental stress or trauma. We studied the relative importance of genetic and environmental factors for problematic masturbatory behavior among nonreferred prepubertal children. All twins born in Sweden in 1985-86 were identified from the Swedish Twin Registry. Parents, mainly mothers, completed Child Behavior Checklist (CBCL) ratings (Achenbach, 1991) for 401 monozygotic (MZ) and 248 dizygotic (DZ) same-sex twin pairs (male-male or female-female) at age 7-9 years. Scores of two CBCL items concerning specific sexual behavior problems (Plays with own sex parts in public and Plays with own sex parts too much) were summed and the influence of genetic and environmental factors on variability assessed. The prevalence of problematic child masturbatory behavior was low and associated with other emotional and behavioral problems. The degree of problematic child masturbatory behavior resemblance was higher within MZ twin pairs as compared to DZ same-sex twin pairs. Model fitting indicated that genetic factors substantially influenced the studied behaviors (77%, 95% CI = 9-96%), although family environment also played a role. Our results suggest that hereditary factors should be considered together with stressful experiences such as sexual victimization in the evaluation of elementary school children presenting with problematic masturbatory behaviors. When interpreting the findings, the very brief measure of sexual problem behavior and low statistical power, precluding the analysis of possible coinheritance with other symptoms or disorders, should be borne in mind.

Predisposing factors in childhood masturbation in Turkey.

UNLABELLED: The aim of this prospective, referral-based study was to assess demographical and developmental features associated with childhood masturbation in Turkey. A total of 61 children with childhood masturbation who were referred for the first time to the Department of Child Psychiatry were examined from demographical, psychosocial and medical aspects and compared with two control groups consisting of 61 age and gender matched children who were brought to the paediatric outpatient clinics and 43 children and adolescents who were the biological siblings of the study group. In children with masturbation, sleep difficulties were more frequent (P < 0.001) and breast-feeding was shorter than in controls (P < 0.05). The onset of masturbation was often associated with a genito-urinary disorder or a stressful life event like weaning, the birth of a sibling, or separation from the parents. CONCLUSION: This is the first controlled study investigating the clinical and the developmental features of childhood masturbation. These findings may help identify children who could be at risk for this condition.

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.

[A little-known epileptic phenomenon]. / Ob odnom maloizvestnom épilepticheskom fenomene.

The epileptic patients were investigated in different age groups displaying hypersexual paroxysms resulting in masturbation. In adults the EEG monitoring was performed. Both in adults and children, epileptic foci were recorded in the temporal lobes. Apparently similar masturbation attacks had peculiarities typical of children vs. adults. In children, the hypersexuality developed exclusively through the automatisms; in adults the motivated brain operated in the hypersexual paroxysms.