IN NEUROLOGICAL DISEASES: FROM PATHOPHYSIOLOGY TO REHABILITATION

IN NEUROLOGICAL DISEASES: FROM PATHOPHYSIOLOGY TO REHABILITATION

Contents

Preface

Acknowledgment

Chapter 1 Neuroanatomy and Physiology of Human Sexuality

Abstract

Human Sexual Cycle

1) Desire Phase

2) Excitement Phase

3) Orgasmic Phase

Neuroanatomy of Human Sexual Behavior

Hypothalamus

Amygdala

Prefrontal Cortex

Sexual Desire and Sexual Arousal

Neurobiology of Sexual Function

Serotonin

Dopamine

Noradrenaline and Adrenaline

Acetylcholine

Hystamine

Opioids

Sex Hormones

Androgens

Estrogens

Progesterone

Prolactin

Oxitocin

Erection

Hemodynamic of Erection

Innervation of Penis

Spinal Control

Supraspinal Control

Ejaculation

Conclusion

References

Chapter 2 Psychological Aspects of Human Sexuality

Abstract

Introduction

1. Gender Identity, Gender Role and Sexual Orientation

2. Cognition, Emotions and Sexual Behaviour

3. Psycho-Sexual Approach Intervention

4. Sex Counseling in Neurological Diseases

References

Chapter 3 Clinical and Instrumental Diagnosis of Sexual Disorders

Abstract

Introduction

Anatomo-Physiology of Male Sexual Function

Male Sexual Dysfunction

Disorders of Desire

Erectile Dysfunction

Disorders of Ejaculation

Disorders of Orgasm

Disorders of Detumescence

Diagnostic Assessment of Male Sexual Disorders

Anamnesis

Physical Examination

Instrumental Investigation

Conclusion

References

Chapter 4 Sexual Dysfunction and Epilepsy

Abstract

Introduction

Sexual Dysfunction in Epileptic Male Patient

Ictal Sexual Disorders

Interictal Disorders

Prevalence of Sexual Dysfunction

Aetiology

Neurological Factors

Endocrine Factors

Anticonvulsivant Medication

Psychiatric Diseases

Psychosocial Factors

Diagnostic Workup

Treatment

Conclusion

References

Chapter 5 Sexuality after Stroke

Abstract

Introduction

Epidemiology of Stroke

Quality of Life in Stroke Survivors

Sexual Dysfunction after Stroke

Conclusion

References

Chapter 6 Sexual Dysfunction in Multiple Sclerosis

Abstract

Introduction

Prevalence of Male Sexual Dysfunction in Multiple Sclerosis

Pathophysiology of Male Sexual Dysfunction in Multiple Sclerosis

Evaluation of Sexual Dysfunction in Multiple Sclerosis

Clinical Interview

Standardized Questionnaires

Medical Assessment

Multidisciplinary Approach to Sexual Dysfunction in Multiple Sclerosis

Primary Sexual Dysfunction

Secondary Sexual Dysfunction

Tertiary Sexual Dysfunction

Conclusions

References

Chapter 7 Sexuality in Neurodegenerative Disorders

Abstract

Sexual Dysfunction in Dementia

References

Sexual Dysfunction in Parkinson Disease

References

Chapter 8 Sexual Dysfunction in Spinal Cord Injury

Abstract

Introduction

Traumatic Spinal Cord Injury

Non Traumatic Spinal Cord Injury

SCI Syndromes

Physiology of the Erection and Ejaculation

Erection

Ejaculation

Sexual Function in Spinal Cord Lesion Men

Drugs for Spinal Cord Injury and Sexual Dysfunction

Conclusion

References

Chapter 9 Sexuality in Other Neuropsychiatric Disorders

Abstract

9.1. Brain Injury

Hypotalamo-pituitary Trauma

Klùver-Bucy Syndrome

References

9.2. Sexual Headache

References

9.3. Sleep Disorders

Kleine-Levine Syndrome (KLS)

Parasomnias and Forensic Considerations

References

9.4. Other Neurological Diseases

References

9.5. Major Psychiatric Diseases

References

9.6. Iatrogenic Sexual Dysfunction

References

Chapter 10 Treatment and Rehabilitation of Sexual Dysfunctions in Neurological Diseases

Abstract

Introduction

1. Erectile Dysfunction

Local Therapies

Non Surgical Devices

Surgical Treatment

Future Treatment

2. Disorders of Ejaculation

A. Premature ejaculation

B. Anejaculation/Anorgasmia

C. Painful Ejaculation

3. Priapism

4. Abnormal Sexual Desire

A. Hypoactive or Deficient Sexual Desire

B. Hypersexuality

Pelvic Floor Rehabilitation

Sacral Neuromodulation

Conclusion

References

Authors’ Affiliations

Index

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