Chapter

Sexual and Emotional Behaviour in Epilepsy

Sarah J. Wilson and Jessie Bendavid

in Oxford Textbook of Epilepsy and Epileptic Seizures

Published on behalf of Oxford University Press

Published in print December 2012 | ISBN: 9780199659043
Published online December 2012 | e-ISBN: 9780191751363 | DOI: http://dx.doi.org/10.1093/med/9780199659043.003.0035

Series: Oxford Textbook of

Sexual and Emotional Behaviour in Epilepsy

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The focus of this chapter is to review two relatively separate lines of behavioural research investigating sexual and emotional functioning in people with epilepsy, with a view to identifying links between them. In particular, a preliminary framework is proposed that reflects the shared evolutionary origins of these fundamental human behaviours and their common neurobiological substrates in the brain. Our aim is to provide a more cohesive framework for understanding the range of biological, cognitive, and psychosocial factors identified to contribute to the well-documented comorbidities of sexual and emotional dysfunction in epilepsy. Within this framework, two key mechanisms are highlighted based on increasing research recognition of their relevance to sexual and emotional dysfunction, particularly in mesial temporal lobe epilepsy. First, disruption to limbic system function leading to a hyperactive hypothalamic-pituitary axis and subsequent excess hormone secretion. Second, a basic impairment in recognising human facial expressions and associated difficulties perceiving social signals. Research relating to interictal sexual and emotional behaviour both before and after resective epilepsy surgery is considered, from which the importance of the right temporal lobe, and notably the right amygdala is identified. It is hoped that the proposed framework will raise both clinical and research awareness of the commonalities of emotional and sexual difficulties in people with epilepsy, which at present are typically under-diagnosed and under-treated.

Chapter.  8767 words.  Illustrated.

Subjects: Neurology

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