Abstracts

Knowledge obtained with women with epilepsy is used to understand adolescents with epilepsy (AWE). Therefore, it is assumed that AWE have decreased libido, more anovulatory cicles and higher infertility rates. The purpose of the present study was to analyze sexuality in AWE. We also intended to evaluate whether the counseling received by these patients met their needs., We included AWE, from 10 to 20 ys, with the diagnosis of epilepsy, according to ILAE guidelines. Patients were enrolled in a standard questionnaire. All interviews were applied by the same physician with a previous knowledge of the patients[apos] epilepsy history and ancillary exams. Data regarding the first part of the questionnaire was obtained by direct interview addressing personal issues (social and economic class, age, schooling) and epilepsy data. The second part referred to gynecologic data, such as age of menarche, menstrual cycles, periodicity, dysmenorrhea, pregnancy, miscarriage, delivery, post-partum and newborn children. The third and fourth parts consisted of a self-applicable questionnaire, addressing sexual behavior information and counseling, respectively., Twenty-four AWE were enrolled in this study. The mean age was 15.9 ys. Epilepsy onset occurred during adolescence in 18 (75%) and in 6 (25%) during childhood. Four (15.3%) had focal symptomatic epilepsy, 15 (57.7%) focal cryptogenic and 5 (27%) had idiopathic generalized epilepsy. Sixteen (61.5%) patiens were under monotherapy. Mean age of menarca was 11.7 ys. Eight (32%) patients had irregular menstrual cycles. Eleven patients (42.3%) used folinic acid.
Nine (34.6%) AWE were sexually active. Mean age of the first intercourse was 14.6 ys. Seven (77.7%) AWE had an unplanned pregnant and in 3, it was recurrent. Two patients became pregnant during the study.Miscarriage occurred in 2.A suspected abortion occurred in 1 patient.One newborn had a post-natal death.
Regarding counseling, school was responsible for orientation for sexual activity and contraception in 8 cases (30.7%) and gynecologists in 3 (11.5%). One patient was guided by the neurologist and another by a health professional. Contraceptive methods were used by 8 patients, only 4 with appropriate guidance. From the contraceptive methods used: 7 patients used preservative in all intercourses, 1 used preservatives sporadically and none used oral contraceptives. Seven (26,9%)AWE received no counseling., Adolescents with epilepsy have active sexual life, despite their disease. As a result, they suffer consequences from an unconcealed sexual activity with unplanned pregnancies. It is interesting that these patients have more access to physicians than normal adolescents. However, they have less counseling, which is probably related to the fact that patients with chronic diseases are assumed as non-sexually actives. Sexual aspects and contraception requires special attention by the specialists attending adolescents with epilepsy., (Supported by FAPESP05/03309-6.)