Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia; Department of Neurology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia; Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
Department of Pediatrics, Dalhousie University and IWK Health Centre, Halifax, Nova Scotia, Canada.
Neurobiol Dis. 2014 Dec;72 Pt B:125-30. doi: 10.1016/j.nbd.2014.05.016. Epub 2014 May 27.
Gender differences in the incidence and clinical course of acquired and "cryptogenic" epilepsy are reviewed based on a literature search. We emphasized incidence and population-based studies because they are best suited to assess the effect of gender on susceptibility and clinical evolution of these epilepsies and may control for potential confounding factors. However, such studies were only available for a few acquired etiologies. These included tumor, prenatal and perinatal brain insults, cerebrovascular disease, infection, trauma, neurodegenerative disease, and autoimmune disorders. None of these acquired causes has been consistently shown to affect women or men to a greater or lesser degree, although some of the literature is contradictory or inadequate. There is almost no literature that addresses the effect of gender on the clinical course of epilepsy associated with these acquired causes. In addition, most studies of acquired causes do not take into account the incidence of the cause in the population with or without associated epilepsy. In children, "cryptogenic" epilepsy (non-syndromic and without causative MRI lesion) does not appear to have a gender preference and gender does not seem to affect the likelihood of remission. As further population-based studies of the etiology and clinical course of epilepsy are undertaken, it may be worthwhile to more specifically define the role of gender.
基于文献检索，综述了获得性和“隐源性”癫痫的发病率和临床病程中的性别差异。我们强调发病率和基于人群的研究，因为这些研究最适合评估性别对这些癫痫易感性和临床演变的影响，并可以控制潜在的混杂因素。然而，只有少数获得性病因的研究可提供此类数据。这些病因包括肿瘤、产前和围产期脑损伤、脑血管疾病、感染、创伤、神经退行性疾病和自身免疫性疾病。这些获得性病因中，没有一种被一致证明对女性或男性的影响更大或更小，尽管有些文献存在矛盾或不足。几乎没有文献涉及性别对与这些获得性病因相关的癫痫临床病程的影响。此外，大多数获得性病因的研究没有考虑到在伴或不伴相关癫痫的人群中病因的发病率。在儿童中，“隐源性”癫痫（非综合征且无病因 MRI 病灶）似乎没有性别偏好，性别似乎也不会影响缓解的可能性。随着对癫痫病因和临床病程的进一步基于人群的研究，更具体地定义性别作用可能是值得的。
