SEXUAL DYSFUNCTION IN PARTIAL EPILEPSY - A DEFICIT IN PHYSIOLOGICAL SEXUAL AROUSAL

Men and women with epilepsy frequently complain of sexual dysfunction. We studied the sexual response in men and women with partial epilepsy of temporal lobe origin (TLE) by measuring genital blood flow (GBF) d uring sexual arousal. Nine women and eight men with TLE and 12 women a nd seven men as controls completed inventories for symptoms of depress ion, sexual experience, and sexual attitude and underwent measurement of digital pulse and GBF during alternating segments of sexually neutr al and erotic videotape. Subjective ratings of arousal to the videotap e were obtained. We calculated digital pulse and G;BF response as the percentage increase in pulse amplitude during the erotic compared with the preceding sexually neutral film. No subject group reported sympto ms of significant depression on the inventory. However, men and women with epilepsy had fewer sexual experiences than subjects without epile psy, and women with epilepsy imagined specific sexual activities to be more anxiety-producing and less arousing than did women without epile psy. Men and women with TLE had a diminished GBF response. The mean in crease in GBF in men with TLE was 184% versus 660% for controls (p = 0 .01). Women with TLE had a mean increase of 117% versus 161% for contr ols (p < 0.01). Digital pulse did not vary across stimulus conditions. Subjective ratings for all groups indicated moderate sexual arousal. We conclude that there is a diminution in one aspect of physiologic se xual arousal in some men and women with TLE.