RESUMO -Onze pacientes do sexo masculino com epilepsia e queixa de alteração sexual foram submetidos a avaliação multidisciplinar. A média de idade foi 27 anos (20-34), a duração média da epilepsia foi 19 anos (0,5-32) e a frequência média das crises foi duas por semana (0-7). Dez pacientes apresentavam crises parciais e um, mioclônicas. Dez pacientes recebiam drogas antiepilépticas (difenil-hidantoína -1, carbamazepina -8, clonazepam -3, clobazam -2, valproato -3, vigabatrina -1). Segundo os critérios do DSM III -R, as queixas foram disfunção erétil (9), redução da libido (4), froteurismo (4), inibição do orgasmo (3), ejaculação precoce (3), fetichismo (2), voyeurismo (2), exibicionismo (2), pedofilia (1) e aversão sexual (1). A avaliação endocrinológica mostrou hipogonadismo hipogonadotrófico em dois pacientes. A avaliação urológica revelou disfunção erétil orgânica em outros dois. Em um paciente a alteração sexual foi considerada psicogênica. Em seis pacientes não foi possível estabelecer diagnóstico etiológico definitivo. Este estudo mostra que a alteração da sexualidade na epilepsia é multifatorial e necessita de abordagem multidisciplinar. PALAVRAS-CHAVE: epilepsia, sexualidade, endocrinologia, urologia. Sexual disorders in epilepsy: results of a multidisciplinary evaluationABSTRACT -Eleven epileptic men who complained of epilepsy and sexual dysfunction were submitted to a multidisciplinary evaluation. Mean age was 27 years (20-34), mean epilepsy duration was 19 years (0,5-32) and the mean seizure frequency was two by week (0-7). Ten patients had partial seizures and one other had myoclonic epilepsy. Ten patients were treated with antiepileptic drugs (phenytoin -1, carbamazepine -8, clonazepam -3, clobazam -2, valproic acid -3, vigabatrin -1). As defined in the DSM III-R, the complaints were: erectile disorder (9), hypoactive sexual desire disorder (4), frotteurism (4), inhibited orgasm (3), premature ejaculation (3), fetishism (2), voyeurism (2), exhibitionism (2), pedophilia (1) and sexual aversion disorder (1). Two patients showed hypogonadotropic hypogonadism on endocrinologic screening. Urological evaluation disclosed organic erectile dysfunction in other two. One patient had a diagnosis of psychogenic sexual disorder. In six patients a conclusive etiologic diagnosis was not reached This report shows the multifactorial nature of sexual disorder in epilepsy and underlies the need of a multidisciplinar evaluation.KEY WORDS: epilepsy, sexual behavior, endocrinology, urology.A maioria das doenças do sistema nervoso pode interferir na expressão satisfatória da sexualidade 1 , especialmente as que acometem o hipotálamo e o lobo temporal 2 . Em contrapartida, as alterações sexuais estão entre os distúrbios encontrados na epilepsia, afetando em média 38 a 71% dos homens e 14 a 50% das mulheres [3][4][5] . No período intercrítico há relato de várias alterações, tais

We analysed 27 complex partial seizures arising from the temporal lobes recorded on videotape simultaneously with the EEG emphasizing the motor manifestations specially dystonic posturing, ictal paresis and head and eye forced deviation (version). The temporal lobe origin of the seizures was based on the agreement of many scalp-sphenoidal or zygomatic interictal and ictal EEG recordings, CT and MRI findings, interictal and, in some patients, ictal SPECT studies. 8 patients had surgery. In 5 from 7 patients who had temporal lobectomy, mesial temporal sclerosis was the anatomopathological finding and in one patient who had selective amigdalohippocampectomy, hemosiderosis and gliosis probably due to bleeding of a posterior cerebral artery giant aneurysm was found. All patients have been seizure free after surgery. While dystonic posturing and ictal paresis, present in 18 seizures (66.6%), were excellent as lateralizing seizure signs, since they were always contralateral to the ictal onset, contralateral and ipsilateral versive head and eye movements were observed.