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Background

Sexual function can be altered in patients by many neurological disorders affecting the cerebrum, the brain stem, the spinal cord, the spinal roots or the peripheral nerves. It can also be prominently affected in patients with an underlying undiagnosed neurological disease. Traditionally, practising neurologists have not paid much attention to sexual dysfunction in their patients, partly because therapeutic possibilities were scant. Sexual dysfunction, however, is observed in many neurological disorders, and may arise as a primary neurogenic disorder. Although not as obviously limiting as, for instance, paresis and pain, it is most disruptive for patients' lives. With emerging awareness of the primary importance of quality of life as the most important indicator of good patient management, and with the advent of more effective treatment of sexual dysfunction, it is no longer acceptable to ignore this very important dimension of life.

In this review we will present the anatomical and physiological basis of the sexual response, the clinical approach to patients with sexual dysfunction, the characteristics of symptoms in neurological disorders, how to take a case history, diagnostic procedures and the treatment possibilities.