Gender Difference in Epidemiology and Comorbidities of Epilepsy

Gender differences do not play a major role in explaining incidence, prevalence, risk factors, and prognosis of seizures and epilepsy. The incidence of unprovoked seizures and epilepsy is slightly higher in men than in women and differs between the two sexes according to age, genetic background, underlying cause and, to some extent, the epilepsy syndrome. Concealment of the disease by women for sociocultural reasons is another explanation. As with incidence, the prevalence of epilepsy is higher in men than in women and sex dominance shifts between age groups. Migraine, attention-deficit hyperactivity disorder, and several psychiatric illnesses have differing distribution in men and women. In these clinical conditions the risk of seizures is higher than expected and may thus affect men and women to a differing extent. The probability of long-term remission of epilepsy is similar in men and women and differences, where present, remain small when treatment is discontinued. In contrast, mortality from epilepsy prevails in men in both developed and developing countries. The use of antiepileptic drugs differs in men and women because of the differing tolerability and safety profile of the available compounds.