title: Sex differences in seizure types and symptoms.
abstract: BACKGROUND
  Despite the increasing interest in sex differences in disease manifestations and responses to treatment, very few data are available on sex differences in seizure types and semiology. The Epilepsy Phenome/Genome Project (EPGP) is a large-scale, multi-institutional, collaborative study that aims to create a comprehensive repository of detailed clinical information and DNA samples from a large cohort of people with epilepsy. We used this well-characterized cohort to explore differences in seizure types as well as focal seizure symptoms between males and females.
  
  
  METHODS
  We reviewed the EPGP database and identified individuals with generalized epilepsy of unknown etiology (GE) (n = 760; female: 446, male: 314), nonacquired focal epilepsy (NAFE) (n = 476; female: 245, male: 231), or both (n = 64; female: 33, male: 31). Demographic data along with characterization of seizure type and focal seizure semiologies were examined.
  
  
  RESULTS
  In GE, males reported atonic seizures more frequently than females (6.5% vs. 1.7%; p < 0.001). No differences were observed in other generalized seizure types. In NAFE, no sex differences were seen for seizure types with or without alteration of consciousness or progression to secondary generalization. Autonomic (16.4% vs. 26.6%; p = 0.005), psychic (26.7% vs. 40.3%; p = 0.001), and visual (10.3% vs. 19.9%; p = 0.002) symptoms were more frequently reported in females than males. Specifically, of psychic symptoms, more females than males endorsed déjà vu (p = 0.001) but not forced thoughts, derealization/depersonalization, jamais vu, or fear. With corrections for multiple comparisons, there were no significant differences in aphasic, motor, somatosensory, gustatory, olfactory, auditory, vertiginous, or ictal headache symptoms between sexes.
  
  
  CONCLUSIONS
  Significant differences between the sexes were observed in the reporting of atonic seizures, which were more common in males with GE, and for autonomic, visual, and psychic symptoms associated with NAFE, which were more common in females.
authors.affiliation: Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA. Electronic address: ccarlson@mcw.edu.
authors.forename: Chad
authors.initials: C
authors.lastname: Carlson
authors.affiliation: Department of Neurology, New York University School of Medicine, New York, NY, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Dugan
authors.affiliation: Department of Neurology and Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Heidi E
authors.initials: HE
authors.lastname: Kirsch
authors.affiliation: Department of Neurology, New York University School of Medicine, New York, NY, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Friedman
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D015331:Cohort Studies; D004247:DNA / Q000235:genetics; D016208:Databases, Factual; D004828:Epilepsies, Partial / Q000503:physiopathology / Q000523:psychology; D005260:Female; D016678:Genome; D006801:Humans; D008297:Male; D010641:Phenotype; D012640:Seizures / Q000235:genetics / Q000503:physiopathology* / Q000523:psychology; D012727:Sex Characteristics; D055815:Young Adult
chemical_list: D004247:DNA
keywords: Atonic seizures; Déjà vu; Epilepsy; Focal epilepsy; Generalized epilepsy; Seizures; Semiology; Sex