Persistent genital arousal disorder (PGAD) characterized by recurrent and spontaneous orgasmic experience: a case report.

Background: Persistent genital arousal disorder (PGAD) is characterized by symptoms of persistent, spontaneous and unwanted genital arousal without sexual interest or thoughts which can cause significant impairment in psychosocial well-being and daily functioning. PGAD is still an under-recognized clinical entity. There are not yet clear evidence-based treatment recommendations. Case Description: This case describes a 20-year-old woman who has experienced persistent genital arousal symptoms for approximately 5 years. The patient's symptoms are consistent with the general characteristics of PGAD, but the sexual arousal symptoms are characterized by recurrent and spontaneous orgasmic experiences. In addition, the patient developed psychotic symptoms, such as delusion, secondary to sexual arousal symptoms. These experiences cause distress and severely affect the patient's daily life and social functioning. Although the patient had a history of epilepsy, we finally excluded the possibility of epileptic seizures after thorough investigation. After systematic antipsychotic treatment, the patient's symptoms were fully controlled, and the medication remained effective during the maintenance phase of treatment. Conclusions: Our case suggests that the dopamine system may play an important role in pathological processes involving sensory abnormalities, particularly those involving the central nervous system. And the treatment with antipsychotic drugs may be one of the therapeutic directions for PGAD.