Reversible erectile dysfunction in a patient with brain tumor-related epilepsy in therapy with zonisamide in add-on

Literature data do not report any cases of erectile dysfunction (ED) during treatment with new antiepileptic drugs in patients with brain tumors.

Concerning zonisamide (ZNS) therapy, data on sexual dysfunction are not available either in patients with epilepsy or in patients with brain tumor-related epilepsy.

Our case study concerns one patient with partial epilepsy associated with oligoastrocytoma in whom reversible ED developed while taking ZNS. He came to our center already having undergone therapy with phenobarbital, oxcarbazepine, phenitoin, and clobazam. Due to the presence of psychomotor slowness and uncontrolled seizures, we substituted phenobarbital with ZNS 200 mg/day. Main Outcome Measures.  The main outcome measures were seizure frequency and side effects.

During ZNS therapy, we observed beneficial effects on seizure frequency with a notable reduction from 2-3 seizures per day to 2-3 per week. One month after starting therapy with ZNS, the patient complained about ED that disappeared when we suspended the drug.

In the literature on patients with brain tumor-related epilepsy, sexuality is a subject that is often neglected by health-care providers who focus primarily on controlling systemic diseases and maintaining physical comfort. For this reason, the possible impact of antiepileptic therapies on sexuality should be taken into consideration.