Sexual Dysfunction in Male Veterans with Epilepsy

Much has been written about sexual dysfunction in men with epilepsy. We wanted to determine the frequency and nature of sexual disorders in our highly selected population of male veterans. Charts of the 184 men with epilepsy followed in the Neurodiagnostic Clinic, Veterans Affairs Medical Center, Durham, NC were reviewed to determine reports of sexual dysfunction. Demographics, type of epilepsy, localization, and antiepileptic drugs (AEDs) at the time of complaints were noted. These patients were compared to 20 men with epilepsy without reported sexual dysfunction (control group). Forty-one (22%) patients complained of sexual dysfunction (impotence 56%, decreased libido 37%, difficulty maintaining erection 22%, and other disorders 15%). Mean age at evaluation was 48.3 years for patients and 44.8 years for controls. Mean age of onset of seizures was 34.0 and 29.3 years for patients and controls, respectively. 93% of patients and 95% of controls had partial seizures. The AEDs (phenytoin, carbamazepine, valproate, phenobarbital, and primadone) were used with approximately equal frequency in both groups. Fifty-nine percent of patients and 65% of controls were on monotherapy, 34% and 25% on dual therapy, 5% each on triple therapy, and 2% and 5% on no medication. Sexual dysfunction is a common problem in our population of veteran men with epilepsy. Age of onset and type of seizures and the medications used were comparable in patients and controls.