The neuroendocrine basis of sex differences in epilepsy

- Sex differences are apparent in epilepsy.
- The incidence of epilepsy is relatively higher in men than women.
- In women with epilepsy, seizures fluctuate according to menstrual cycle phases.
- The neuroendocrine basis of sex differences in epilepsy remains unclear.
- A mechanistic understanding is needed to optimize gender-specific therapies.

Epilepsy affects people of all ages and both genders. Sex differences are well known in epilepsy. Seizure susceptibility and the incidence of epilepsy are generally higher in men than women. In addition, there are gender-specific epilepsies such as catamenial epilepsy, a neuroendocrine condition in which seizures are most often clustered around the perimenstrual or periovulatory period in adult women with epilepsy. Changes in seizure sensitivity are also evident at puberty, pregnancy, and menopause. Sex differences in seizure susceptibility and resistance to antiseizure drugs can be studied in experimental models. An improved understanding of the neuroendocrine basis of sex differences or resistance to protective drugs is essential to develop targeted therapies for sex-specific seizure conditions. This article provides a brief overview of the current status of sex differences in seizure susceptibility and the potential mechanisms underlying the gender differences in seizure sensitivity.