SEXUAL ACTIVITY AND EPILEPSY
Orgasm in both men and women is presumably accompanied by some sort of ‘paroxysmal discharge of cerebral nerve cells’. This, and the impossibility of control of orgasm beyond a certain point, suggests an analogy with seizures. In fact seizures during or immediately after intercourse are exceptionally uncommon. When they do occur, they probably represent one of the types of reflex epilepsy. Except in these rarer cases, there is certainly no reason for avoiding intercourse on the grounds that seizures may be provoked.
Unfortunately, epilepsy is sometimes accompanied by a decline in sexuality. Many adolescents find their initial dates worrying enough (‘Which cinema should I take her to?’ ‘Should I let him kiss me?’), but how much more worrying must it be to take a girl out knowing that there is a chance, albeit a remote chance, that a seizure will occur during the date? Anxiety about contact with the opposite sex may have its basis in such entirely understandable problems of adolescence. However, there is evidence that a decline in sexuality may occur more frequently in those with seizures arising in the temporal lobe than in other types of seizures. Rarely, libido and potency may improve after temporal lobe surgery.
Sometimes patients may complain about loss of libido and sexual performance after beginning anticonvulsant drugs. This seems to happen most frequently after phenobarbitone and primidone, but it is difficult to be sure how much is due to the drugs, and how much to social and psychological factors.
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