Gender differences in epilepsy

Purpose: The aim of this study was to look at gender differences in unselected populations of patients with epilepsy classified according to the 1989 International League Against Epilepsy (ILAE) criteria. Methods: Data were obtained from two sources: (a) the EpiBase database at the outpatient clinic at the Department of Neurology, Aarhus University Hospital, Denmark, confined to adults with epilepsy (n = 2,170), and (b) the Danish Twin Registry (n = 318). Results: In localization-related epilepsy, no overall gender difference was found in either the EpiBase population (n = 1,511; w = 750 (50%), in = 761 (50%); p = 0.80) or in the twin population (n = 172; w = 86 (50%), in = 86 (50%); p = 1.00). However, in the EpiBase population, localization-related symptomatic epilepsies were more frequent in men (n = 939; w = 426 (45%), in = 513 (55%); p = 0.005); and cryptogenic localization-related epilepsies were more frequent in women (n = 572; w = 324 (57%), m = 248 (43%); p = 0.002). In generalized epilepsy, more women than men were diagnosed in both populations [EpiBase: n = 480, w = 280 (58%), m = 200 (42%); p < 0.001; twin population: n = 105, w = 63 (60%), m = 42 (40%); p = 0.051. The difference was confined to idiopathic generalized epilepsy [EpiBase: n = 437, w = 259 (59%). m = 178 (41%); p < 0.001; twin population: n = 94, w = 60 (64%), m = 34 (36%); p = 0.01]. Conclusions: More women than men were diagnosed with idiopathic generalized epilepsy in two epilepsy populations. Overall, no gender difference was found in localization-related epilepsy, but localization-related symptomatic epilepsies were more frequent in men, and cryptogenic localization-related epilepsies were more frequent in women The results suggest a gender susceptibility to the development of specific epilepsy sub-types.