domingo, 18 de agosto de 2013

Erectile function in men with epilepsy: relationship to psychosocial-, hormonal-, epilepsy- and antiepileptic drugsrelated variables

Erectile dysfunction (ED) is common with epilepsy. We aimed to determine the frequency of ED in epileptic adults and its related variables. Included were 100 epileptic men treated with conventional antiepileptic drugs (AEDs). Patients were assessed using International Index of Erectile Function questionnaire-5 items version (IIEF-5), psychiatric interview, Beck Depression Inventory (2nd edition) (BDI-II) and Hamilton Anxiety Rating Scale (HAM-A). Free testosterone and sex hormone binding globulin (SHBG) were measured to assess endocrinal status. Compared to controls (n=50), patients had higher rates of ED (37%), lower IIEF-5 scores (P=0.053), particularly with frontal lobe epilepsy, left foci, carbamazepine (CBZ) and uncontrolled seizures. A high frequency of depression (51%) and scores of BDI-II were reported with frontal lobe epilepsy, right foci, CBZ, polytherapy and lack of control on AEDs. Lower free testosterone and higher SHBG levels were also reported. Patients with ED were older in age, had higher rates of uncontrolled seizures (58.19%) and higher scores of BDI-II and HAM-A. A significant negative correlations were identified between ED and age, age at onset, scores of BDII and HAM-A. We concluded that psychiatric comorbidity and endocrine abnormalities appear to be related to ED and seizure intractability to AED medications. Attention should be paid to optimize seizure control. In addition, psychotherapy and modalities such as medications for ED are sometimes needed.

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