Sexual Problems in Patients Suffering from Multiple Sclerosis

Lilius, H. G.; Valtonen, Erkki J.; Wikström, Juhani

doi:10.1177/140349487600400308

Cited by 20 publications

(24 citation statements)

References 1 publication

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“…Consistent with other studies (Minderhoud et al, 1984;Mattson et al, 1995), ED was only slightly associated with sensory involvement at lower limbs, conversely the association was strong with urinary disturbances (Miller et al, 1965;Vas, 1969;Lilius et al, 1976;Minderhoud et al, 1984;Valleroy and Kraft, 1984;Betts et al, 1994;Mattson et al, 1995;H u h and Lundberg, 1995). A close relationship was also found between ED and abnormal cystometric results in impotent male subjects (Stenager er al., 1992;Betts et al, 1994).…”

Section: Discussionsupporting

confidence: 88%

“…The two causes are likely to be associated and reciprocally involved (Jensen, 1992;Stenager ef al., 1992;Dupont, 1995): anxiety, depression, feeling of dis-SEXUAL DYSFUNCTION M MALE MS PATIENTS comfort due to the handicap can worsen or precipitate erectile impotence, or can contribute to maintain it, amplifying the effects of lesions along the neuraxis. The presence of bladder and of motor/sensory involvement at lower extremities is considered consistent with the organic nature of ED by some authors (Lilius et al, 1976;Minderhoud et al, 1984; Valleroy and Kraft, 1984). In our series nearly all patients of group B and C presented motor disturbances of lower limbs but the frequency of motor involvement at legs was also high in sexually asymptomatic patients.…”

Section: Discussionsupporting

confidence: 64%

“…These different extimates are likely to depend on several factors such as the methods of selection and assessment of patients, the characteristics and the size of groups studied. Erectile dysfunction (ED), with defect or loss in maintaining erections, is reported as the predominant symptom, ejaculatory dysfunction being less frequent (Lilius et al, 1976;Vas, 1969;Minderhoud et al, 1984; Valleroy and Krafi, 1984;Mattson et al, 1995).…”

Section: Introductionmentioning

confidence: 99%

“…Disturbances of sexual function have not been so widely investigated in females but, on the whole, appear less frequently than in males (Lilius et al, 1976; Minderhoud et al, 1984;Mattson et al, 1995): they mainly consist in defect or loss of vaginal lubrication, absence of orgasm, defect of vaginal sensation, dyspareunia (Lilius ef al., 1976; Lundberg, 1978;Minderhoud et al, 1984; Valleroy and Kraft, 1984;Mattson et al, 1995; Hulter and Lundberg, 1995).…”

Section: Introductionmentioning

confidence: 99%

“…Most authors have found a relationship between ED and bladder involvement (Miller et al, 1965;Minder-houd et al, 1984;Kirkeby et al, 1988;Mattson et al, 1995). The relationship with the degree of pyramidal involvement, disability, course and duration of the disease seems less clear (Lilius et al, 1976;Minderhoud et al., 1987; Valleroy and Kraft, 1984;Mattson et al, 1995). Neurophysiological Patients were submitted to an ad hoc questionnaire, after they had been informed about the aim of the study and had given their consent; assistance was given to explain and/or fill out the form, if required.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Sexual dysfunction in male multiple sclerosis patients in relation to clinical findings

Ghezzi¹,

Zaffaroni²,

Baldini³

et al. 1996

Euro J of Neurology

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Seventy‐seven consecutive male patients with clinically definite or laboratory supported definite multiple sclerosis were submitted to a questionnaire and a clinical interview in order to assess the frequency, the nature of sexual dysfunction and its relationship with clinical findings. Twenty‐six patients (35%) complained of erectile dysfunction: the defect was partial and inconstant in 11 patients (14%), complete and fixed in 15 (21%). Six patients complained of premature ejaculation, in three of whom the symptom was already present before the onset of the disease. Taking the series as a whole, sexual life was poor or not satisfying at all in 34 patients. Erectile dysfunction was associated with the presence and severity of bladder dysfunction and with disability. The relationship with sensory impairment of legs was slight, no relationship was found with motor involvement of legs, type of course, age and disease duration.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Sexual dysfunction in male multiple sclerosis patients in relation to clinical findings

Ghezzi¹,

Zaffaroni²,

Baldini³

et al. 1996

Euro J of Neurology

View full text Add to dashboard Cite

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Penile prosthesis for impotence in multiple sclerosis

Massey

Pleet

1979

Annals of Neurology

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Loss of libido and impotence are common problems for patients with multiple sclerosis. A penile implant may correct one aspect of sexual dysfunction in selected males.Massey EW, Pleet AB: Penile prosthesis for impotence in multiple sclerosis. Ann Neurol 6145 1-453, 1979 Impotence may result from psychogenic or organic factors, or both. Although 90% of reported cases of impotence are due to psychogenic factors, 10% result from organic causes such as vascular disease, neuromuscular disease, endocrine or metabolic aberrations, pelvic surgery, trauma, or medication. Whether of psychogenic o r organic cause, impotence is a problem which physicians must discuss freely with their disabled patients.Neurological disease can cause impotence with or without failure of ejaculation; multiple sclerosis (MS) represents no exception. h e r s and Goldstein [l] reported impotence in 26% of their male patients with MS; in 3% it was the principal symptom. Vas [ 5 ] observed that 47% of his male patients had erectile insufficiency despite the absence of marked neurological disability. Lilius et a1 [2], using data generated from questionnaires returned by 302 MS patients, reported a change in the sexual lives of 9 1 % of the men and 77% of the women; half of each group reported either unsatisfactory or absent sexual activity. An inadequate erection was reported by 62% of the men; indeed, a fully adequate erection was achieved by only 20% of the men reporting. Women complained of inability to attain orgasm (33%), loss of libido (27%), and interference with the sexual act because of spasticity (12%).While psychogenic factors may play a role in the genesis of sexual incompetence in MS patients, organic factors become increasingly frequent. Spasticity can be treated with a variety of medications, with

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Paroxysmal choreoathetosis associated with thyrotoxicosis

Fischbeck

Layzer

1979

Annals of Neurology

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0364-5 1341791A 35-year-old woman was admitted with complaints of weakness and muscle spasms. Grand ma1 seizures had begun at age I 3 years and responded well to treatment with phenobarbital and phenytoin. At age 26 she had had an episode of status epilepticus, which left her with memory impairment that recovered after several months. Eighteen months prior to admission, dysphagia, diplopia, dysarthria, and generalized weakness developed. Myasthenia gravis was diagnosed o n the basis of response to anticholinesterase treatment. Around the same time she began to have episodes of generalized tonic spasm involving the face, arms, and legs. H e r workup at another hospital was unremarkable except for right temporal slowing on one electroencephalogram and a small area of low density in the high right parietal area o n a C T brain scan. She tolerated anticholinesterase treatment poorly, and her myasthenic symptoms gradually progressed. The episodes of muscle spasm became more severe and more frequent, occurring an average of once per week in the month before admission. Raising her arms over her head seemed to precipitate the attacks, which were more common when she was tired or excited. She did not drink alcohol and had n o family history of a similar disorder. She had taken no medication for several months before admission. General examination at admission was remarkable for proptosis, greater on the right than the left, and a precordial systolic ejection murmur. She was diaphoretic, though vital signs were normal. Neurological examination showed decreased eye movements with contracture of the right lateral rectus muscle, nasal speech, facial weakness, and reduced vital capacity. There was weakness of the neck and proximal arm muscles. Deep tendon reflexes were increased in the legs, but plantar reflexes were flexor. She had a fine tremor of the fingers and slight continual choreiform movements, particularly in the left hand and foot .Treatment with pyridostigmine, atropine, and phenytoin was started. While in the hospital the patient was noted to have episodes of paroxysmal choreoathetosis, which she called "muscle spasms," one to four times per day. The episodes usually lasted one or two minutes and began in the left arm, with tonic flexion of the fingers, wrist, and elbow and occasional coarse, rhythmic shaking of the hand. The tonic spasm would spread to involve the face, which would be contorted, with the mouth drawn open and a fixed stare. The right arm was involved in a similar manner, though less severely, and the trunk and legs were usually held in tonic extension. She remained conscious throughout, although unable t o speak, and as soon as the episode ended she was able to give a detailed account of the events that had transpired. An electroencephalogram showed only diffuse slowing. The episodes continued despite treatment with phenytoin at 300 mg per day (serum level, 10 pg/ml) and did not respond to intravenous administration of diphenhydramine or benztropine. She was started on clonazepam. O n the fourth h...

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Sexual Problems in Patients Suffering from Multiple Sclerosis

Cited by 20 publications

References 1 publication

Sexual dysfunction in male multiple sclerosis patients in relation to clinical findings

Sexual dysfunction in male multiple sclerosis patients in relation to clinical findings

Penile prosthesis for impotence in multiple sclerosis

Paroxysmal choreoathetosis associated with thyrotoxicosis

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