14th Congress of the European Federation of Neurological Societies
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Epilepsy and Sexuality
Gerhard Luef
Gerhard Luef
Innsbruck, Austria  
Topic: Other
57 slide(s) – 00:32:23– English –2010-09-26
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Sexuality is an important and private aspect of life and sexuality and epilepsy have been intimately linked since ancient time. In the modern medical era of epilepsy Gastaut and Collomb published that many patients with complex partial seizures have an apparent lack of interest in sexual activity. Sexual dysfunction is frequently reported by patients with epilepsy. Despite its fundamental role in human life, there has been surprisingly little research into the neurological control of human sexual behaviour. Multiple causes may lead to sexual dysfunction. The basis for hyposexuality has been attributed to both epilepsy and antiepileptic drug (AED) use, making it difficult to distinguish between the illness-specific and pharmacological impacts on sexual functioning. Low levels of androgens are associated with sexual arousal insufficiency and sexual dysfunction.When examining sexual dysfunction in men and women with epilepsy, the Arizona Sexual Experience Scale (ASEX) may be helpful in evaluating sexual function. Laboratory tests for oestrogen, free and total testosterone, and serum SHBG may also be useful in evaluating sexual health. Sporadic case studies suggest that hypersexuality is a rare but dramatic outcome of unilateral temporal lobectomy. Sexual seizure manifestations are also rare clinical phenomena during or after complex partial seizures that have received attention in the recent literature. Both, men and women with epilepsy appear to have altered gonadal function. It is still unclear whether AEDs or epilepsy cause the abnormality involving prolactin, luteinizing hormone (LH), estradiol, SHBG, and dehydroepiandrosterone (DHEA) in women and also follicle stimulating hormone (FSH), free testosterone (FT), inhibin, DHEA, and 17-OH progesterone in men with epilepsy.
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