Sexual Behavior in Temporal Lobe Epilepsy

Blumer, Dietrich; Walker, Anne

doi:10.1001/archneur.1967.00470190041005

Cited by 138 publications

(62 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Trimble (19) reviewed all data available from temporal lobectomy series, calculated that postoperative de novo psychoses developed in 3.8-35.7% (mean, 7.6%) of patients and concluded that in at least some cases a causal relation (by way of "forced normalization") may be suggested. On the positive side, what is usually termed "aggression" appears to be improved after surgery (20,2 l), and the preoperative hyposexuality tends to be normalized postoperatively if the seizures are completely eliminated (22).…”

mentioning

confidence: 99%

Psychiatric Outcome of Temporal Lobectomy for Epilepsy: Incidence and Treatment of Psychiatric Complications

et al. 1998

Self Cite

View full text Add to dashboard Cite

Summary: Purpose: To determine the incidence of psychiatric disorders before and after surgical treatment for partial epilepsy and to document the effectiveness of their treatment.Methods: Fifty consecutive patients treated surgically for focal epilepsy (44 temporal and six frontal) were evaluated by established neuropsychiatric methods before surgery and over a mean period of 2 years after surgery. The patients with interictal dysphoric disorders, with or without psychotic episodes, were treated witli tricyclic antidepressant medication alone or combined with serotonin selective reuptake inhibitors and, if necessary, with the addition of risperidone.Results: Before surgery, 25 (57%) of the 44 patients with temporal lobe epilepsy had dysphoric disorders. After surgery, 17 (

show abstract

mentioning

confidence: 99%

Psychiatric Outcome of Temporal Lobectomy for Epilepsy: Incidence and Treatment of Psychiatric Complications

et al. 1998

Self Cite

View full text Add to dashboard Cite

show abstract

“…Most of the literature regarding the effect of epilepsy on sexual function has focused on men. This literature has described a global hyposexuality in 30-66% of men that manifests as reduced libido/desire and impotence (41)(42)(43)(44). Studies on sexual function in women with epilepsy are more limited and are colored by cultural biases about what constitutes appropriate sexuality.…”

Section: Sexual Dysfunction Prevalencementioning

confidence: 99%

“…Studies on sexual function in women with epilepsy are more limited and are colored by cultural biases about what constitutes appropriate sexuality. This has led to reports of widely variable frequencies of sexual dysfunction: 14% in Egypt (41), 29% in Scandinavia (45), and 3 6 5 0 % in the United States (42,46).…”

Section: Sexual Dysfunction Prevalencementioning

confidence: 99%

Effects of Epilepsy on Women's Reproductive Health

Morrell

1998

Epilepsia

View full text Add to dashboard Cite

Summary:Reproductive dysfunctions are common and wideranging in women with epilepsy. Menstrual cycle disruption, anovulatory cycles, disturbances in hypothalamic andor pituitary hormones, and disturbances in gonadal steroids are more common among women with epilepsy. Sexual dysfunction can present as either disorders of desire or physiologic arousal, but the most common dysfunction appears to be an inadequate initial physiologic arousal response. Reproductive dysfunctions may be due to psychologic, pharmacologic, or physiologic factors. Physicians should routinely question all women with epilepsy regarding their reproductive and sexual health. A full history, a complete physical, and laboratory evaluations with endocrinologic work-up should be performed in any woman who reports a reproductive dysfunction. Treatment a n d or referral to a gynecologist or endocrinologist should be initiated as appropriate.

show abstract

“…Studies evaluating sexual attitude and behavior find an incidence of sexual dysfunction ranging from 30-66% of men with epilepsy (4749) and from 14-50% of women (48,50,51). Although women and men with epilepsy may often experience disorders of sexual desire, disorders of sexual arousal are at least as common.…”

Section: Sexualitymentioning

confidence: 99%

Maximizing the Health of Women with Epilepsy: Science and Ethics in New Drug Development

Morrell

1997

Epilepsia

View full text Add to dashboard Cite

Summary:Issues of unique concern to women with epilepsy largely arise from gender-based physiological differences. Female sex steroid hormones may alter the expression of epilepsy and the efficacy of antiepileptic drugs (AEDs). Seizures and AEDs in turn affect the hypothalamic-pituitary axis and can adversely impact reproductive function and bone health. Maternal seizures and exposure to AEDs may compromise fetal development. At this time, women with epilepsy and their medical caretakers do not have access to all the information necessary to formulate a treatment plan that will have the least impact on reproductive and general health. In part, this is because reproductive aged women are excluded from the earliest phases of drug testing and pregnant and lactating women are excluded from all aspects of new drug development. Therefore, as new AEDs enter the marketplace, women with epilepsy must decide whether a new AED is appropriate for therapy based on very limited information. Postmarketing surveillance of gender-specific adverse effects, as with all adverse effects, depends on voluntary reporting. Only a small percentage of significant adverse events are believed to be captured by the present system. Consumers, ethicists, and some physician groups are now arguing that women should be included in all aspects of the development of drugs they will ultimately use-even pregnant and lactating women. Some of the issues of concern for women with epilepsy regarding epilepsy treatment, reproductive function and general health will be reviewed, followed by a discussion of the drug development process and how it does, and could better, address the concerns of women. Key Words: Epilepsy-Women-Anticonvulsant drugs-HormonesDrug therapy-Drug toxicity-Reproduction-Clinical drug evaluation-Clinical trials-Fertility-Teratogens. EFFECT OF HORMONES ON SEIZURES AND ON AED EFFICACYSteroid hormones are active in the central nervous system (CNS) and may alter the seizure threshold to a clinically significant extent (1). The ovarian sex steroid hormones, estrogen and progesterone, appear to act in an opposing fashion to modulate excitability of neurons of the cerebral cortex ( 2 ) . Estrogen has a seizure activating effect in experimental models of epilepsy such as the electroshock seizure threshold and after creation of a new seizure focus. Progesterone has an inhibitory effect in these same models. In human females, estrogen appears to activate interictal epileptiform activity whereas progesterone and its reduced metabolites reduce epileptiform activity.Both estrogen and progesterone exert their opposing effects, at least in part, at the GABA-A receptor complex (3). A recognition site for these neuroactive steroids has been identified on the GABA-A receptor complex (43). When k strogen occupies the receptor site, chloride conductance through the receptor is reduced, whereas progesterone has the opposite effect. Estrogen and progesterone also alter RNA encoding the synthesis of the GABA-A receptor complex and of GABA itselfprobably thr...

show abstract

Sexual Behavior in Temporal Lobe Epilepsy

Cited by 138 publications

References 9 publications

Psychiatric Outcome of Temporal Lobectomy for Epilepsy: Incidence and Treatment of Psychiatric Complications

Psychiatric Outcome of Temporal Lobectomy for Epilepsy: Incidence and Treatment of Psychiatric Complications

Effects of Epilepsy on Women's Reproductive Health

Maximizing the Health of Women with Epilepsy: Science and Ethics in New Drug Development

Contact Info

Product

Resources

About