Objective: Hormonal changes and abnormalities in reproductive function may occur in patients with epilepsy. This study aimed to investigate the abnormalities in the reproductive functions in male patients with epilepsy under antiepileptic treatment and its negative impact on their children. Materials and Methods: A total of 104 participants were included in the study, wherein 52 were patients and 52 were healthy controls. Medical history and completed neurological examination were performed on all participants. Each participant filled out the International Index of Erectile Function (IIEF) and Beck depression scale. Serum hormones and biochemistry tests were also checked. Electroencephalography that was performed within the last 6 months and cerebral imaging anytime during the follow-up period were retrospectively evaluated. The Statistical Package for the Social Sciences 20.0 program was used for statistical evaluation. Results: The mean age of the male patients with epilepsy was 29.1±5.5 years. The prevalence of erectile dysfunction was 63.5% in male patients with epilepsy, and 40.4% of the patients developed erectile dysfunction after antiepileptic drug use. Patients on polytherapy were found to have a higher risk of depression. Furthermore, patients with intractable seizures were more depressed (p=0.044). Beck scale and IIEF scores negatively affected each other (rs: -0.568). Patients with polytherapy have higher estrogen levels, whereas the luteinizing hormone levels were lower. Congenital malformation percentage is defined by 4.2% in children of male patients with epilepsy. Two of them have atrial septal defects and 1 with foramen ovale. Conclusion: The possibility of congenital malformation and abnormalities in the children of male patients with epilepsy should not be overlooked. Patients and their relatives should be provided with the necessary support and information after careful risk assessment.
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Objectives: What is expected from anti-epileptic treatment is low side effects and drug-drug interactions as well as high efficacy. In this study, the efficacy of lacosamide in polytherapy and its effect on prognosis were evaluated. Methods: Seventy-seven patients with focal epilepsy who were followed up for at least 1 year and using lacosamide were included in the study. The antiepileptic drugs they use, the side effects of the drugs, neuroimaging and electrophysiological examinations were evaluated. Results: A total of 77 patients, including 35 women (44.9%) and 42 men (55.1%), were included in the study. The mean age was 33.9±10.6 (min: 19 max: 67). Average age of seizure onset was 12.6±10.7, and none of the patients were using Lacosamide (LKS) as monotherapy. Although only 3 patients were receiving dual therapy, the remaining 74 patients were receiving 3 or more antiepileptic treatments. While 33 of the patients (42.9%) had a decrease in the frequency of seizures after LKS treatment. Conclusion: Although the percentage of efficacy was obtained as low according to literature information, lacosamide is effective in resistant focal epilepsies with an efficiency of 42.9%. Especially in patients who use drugs other than antiepileptic drugs due to comorbid diseases, the absence of drug-drug interaction and the absence of serious side effects that require termination of treatment may be an indication that it can be used safely.
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