Sureka Rajendra Kumar, Gaur Vikas, Purohit Gaurav, Gupta Medha
Department of Neurology, Mahatma Gandhi Medical College, Jaipur, Rajasthan, India.
Department of Psychiatry, Mahatma Gandhi Medical College, Jaipur, Rajasthan, India.
Ann Indian Acad Neurol. 2021 Sep-Oct;24(5):726-731. doi: 10.4103/aian.AIAN_1023_20. Epub 2021 Aug 4.
Epilepsy is the second most common neurological disorder, and it may have a significant effect on sexual functions in epileptic patients.
Sexual dysfunctions were assessed in 146 male patients suffering from generalized tonic-clonic seizure (GTCS) with a seizure-free interval of at least 1 year. Out of 146 patients enrolled, 46 patients had a psychiatric impairment and were excluded from the study, after applying the General Health questionnaire12 (GHQ12) scale and detailed psychiatric evaluation. The remaining patients were evaluated for the presence of sexual dysfunction by applying Arizona Sexual Experience scale (ASEX). Sixty-six patients scoring more than 19 as a cutoff score on the ASEX scale were further interviewed by a psychiatrist, and a diagnosis of sexual dysfunction was made as per ICD 10 Diagnostic criteria.
Sexual dysfunction was diagnosed in 66% (n = 66) of the patients. Erectile dysfunction was the most common sexual disorder diagnosed in 36% of the patients (n = 36) followed by premature ejaculation in 26% (n = 26) and seen in 4% (n = 4) of the patients. In patients with sexual dysfunction, a significant association was observed with the duration of epilepsy and type of therapy (mono/polytherapy) ( value < 0.05). Erectile dysfunction and hypoactive desire were more common in patients taking polytherapy, whereas premature ejaculation was more common in patients on monotherapy.
Significant impairment of sexual functions was observed in male epileptics with GTCS. A high index of suspicion should be kept in mind by the practicing clinician on diagnosing and treating sexual dysfunction in them.
癫痫是第二常见的神经系统疾病，可能对癫痫患者的性功能产生重大影响。
对146例全身性强直阵挛发作（GTCS）且发作间期至少为1年的男性患者进行性功能障碍评估。在纳入的146例患者中，应用一般健康问卷12（GHQ12）量表并进行详细的精神评估后，46例有精神障碍的患者被排除在研究之外。对其余患者应用亚利桑那性体验量表（ASEX）评估性功能障碍的存在情况。ASEX量表得分超过19分作为临界值的66例患者由精神科医生进一步访谈，并根据国际疾病分类第10版（ICD 10）诊断标准做出性功能障碍的诊断。
66%（n = 66）的患者被诊断为性功能障碍。勃起功能障碍是最常见的性功能障碍，36%（n = 36）的患者被诊断为此种障碍，其次是早泄，26%（n = 26）的患者有此问题，4%（n = 4）的患者有性欲减退。在性功能障碍患者中，观察到与癫痫病程和治疗类型（单药/联合用药）有显著相关性（P值< 0.05）。联合用药的患者中勃起功能障碍和性欲减退更为常见，而单药治疗的患者中早泄更为常见。
全身性强直阵挛发作的男性癫痫患者存在明显的性功能损害。临床医生在诊断和治疗他们的性功能障碍时应保持高度的怀疑指数。
