Sex differences among epileptic patients: a comparison of epilepsy and its impacts on demographic features, clinical characteristics, and management patterns in a tertiary care hospital in Egypt

Abstract

Background: Epilepsy is one of the most common neurological conditions. We aimed to identify sex differences in the demographic, clinical features, and treatment strategies in epileptic patients. Objectives: To analyze and compare the differences in the impact of epilepsy on the socio-demographic characteristics of male and female patients along with gender differences in various types of epilepsies and treatment strategies. Material and methods: A record-based study for 1000 individuals attending the epilepsy outpatient clinic. The medical records were reviewed through a predesigned questionnaire to obtain all relevant data. Statistical analysis: Data was summarized using range, mean, standard deviation, and median interquartile range for quantitative variable or frequency and percentage for the qualitative ones. Comparison between groups was done using chi-square test. Results: Females were more illiterate and unemployed compared to males. Tonic-clonic seizures were more frequent in males. Specific epileptic syndromes as juvenile myoclonic epilepsy (JME) were more frequent in females (p = 0.01). More males had an underlying secondary etiology (p = 0.001). The most common drug used was valproate (51.2%) which was more utilized by males. Conclusions: Significant differences between both sexes were observed in certain social impacts in addition to seizure syndromes, etiology, and drug utilization.

Diagnostic difficulties in patients with juvenile myoclonic epilepsy

“…Usually the first seizures between 12 and 18 years of age are well recognized (11,12). There are many studies showing female dominance for JME (13,14,15). In our study, in accordance with the literature, 48 (64%) of the patients were female, 27 patients (36%) were male and the female-male ratio was 1.7/1.…”

Sex Differences in the Epilepsies and Associated Comorbidities: Implications for Use and Development of Pharmacotherapies

“…Clinical Studies. Some studies have reported a greater rate of generalized tonic-clonic seizures in males (Hauser et al, 1993;Kishk et al, 2019), although other studies have found either no sex difference (Carlson et al, 2014) or increased generalized tonicclonic seizures in females (Mullins et al, 2007). The variability in these effects across studies may reflect relatively small sample sizes and/or differences in reporting across countries.…”

Seroprevalence of Anti- N-methyl-D-aspartate receptor antibodies in children with seizures of unknown cause

“…31 Variable results were reported about sex difference for seizure types, some showed that idiopathic generalized epilepsy or multiple seizure types are more common in females. 32 Other reported that atonic seizures were more common in males with generalized epilepsy, and that autonomic, visual, and psychic symptoms associated with nonacquired focal epilepsy, were more common in females. 33 The current study reported no one in the control group with positive anti-NMDAR antibodies, in contrast to other studies which showed positivity in the serum of healthy persons as in USA in 2014 (0.4%) and in Germany in 2013 (3%).…”