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Andrew G. Herzog, MD, MS; Linda A. Levesque
Neuroendocrine Unit Beth Israel Hospital 330 Brookline Ave Boston, MA 02215

Arch Neurol. 1992;49(2):133-134.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—I would like to bring attention to an article by Isojärvi et al¹ in which they report three separate measures of serum testosterone in anticonvulsant-treated men with epilepsy. The authors show how the use of a particular medication or combination of medications can be associated with elevated total testosterone, yet normal free testosterone and low free androgen index values. Their elegant data highlight an important issue. Namely, if androgen deficiency contributes to reproductive and sexual dysfunction in men with epilepsy,^2-6 which testosterone measurement is most relevant?

Reproductive dysfunction and hyposexuality are unusually common among men with epilepsy.^7-14 Their cause is likely multifactorial, including psychosocial, epileptic, medicational, and hormonal factors.¹¹ Because androgens are considered to play an important role in the regulation of potency and libido,^15,16 measurement of their serum levels is a regular part of the medical evaluation. The most important androgen . . . [Full Text PDF of this Article]

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