Sex and hormonal influences on seizures and epilepsy

This article is part of a Special Issue "Hormones & Neurotrauma".Epilepsy is the third most common chronic neurological disorder. Clinical and experimental evidence supports the role of sex and influence of sex hormones on seizures and epilepsy as well as alterations of the endocrine system and levels of sex hormones by epileptiform activity. Conversely, seizures are sensitive to changes in sex hormone levels, which in turn may affect the seizure-induced neuronal damage. The effects of reproductive hormones on neuronal excitability and seizure-induced damage are complex to contradictory and depend on different mechanisms, which have to be accounted for in data interpretation. Both estradiol and progesterone/allopregnanolone may have beneficial effects for patients with epilepsy. Individualized hormonal therapy should be considered as adjunctive treatment in patients with epilepsy to improve seizure control as well as quality of life.

► Seizure disorders are more common in males compared to females. ► There is a reciprocal relationship between sex hormones and seizures. ► Effects of sex hormones on seizures are complex and often misinterpreted. ► Sex hormones may be considered as adjunctive therapy in epileptic patients.