Jennifer McQueeny,1 Andrew Mettias,1 Matthew Kao,1,2 Janette Bow-Keola,1,2 Tyrone Sumibcay,1,2 Kore Kai Liow,1,2 Darren DuGas,1 Enrique Carrazana2
1 Comprehensive Epilepsy Center and Video-EEG Epilepsy Monitoring Unit & Epilepsy Research Unit, Hawaii Pacific Neuroscience, Honolulu, HI
2 John A. Burns School of Medicine, University of Hawaiʻi, Honolulu, HI
Background: Current research recognizes sex-based differences in etiology and comorbidity patterns among people with epilepsy (PWE). However, much remains unanswered among Hawaii’s diverse landscape. This study characterizes the differences in seizure etiologies and comorbidity profiles between male and female PWE within Hawaii’s population.
Methods: A retrospective chart review was performed on 500 PWE who received care at Hawaii Pacific Neuroscience between January 2019 – July 2020. Data on seizure type, epilepsy etiology, and associated comorbidities were gathered. Statistical analyses were conducted using chi-square and one-way ANOVA.
Results: No differences were observed among age and seizure types, but emerged among etiologies and associated comorbidities. Women had a higher aggregate burden of psychiatric comorbidities (p<0.001), including anxiety (p=0.006), depression (p=0.002), and post-traumatic stress disorder (PTSD) (p=0.047). The total burden of neurological comorbidities was higher in women (p=0.031), notably migraines (p<0.001) and sleep disorders (p=0.043). The etiologies of epilepsy differed: structural causes attributable to traumatic brain injury (TBI) were more common among men (p=0.006) while malformations of cortical development (MCD) (p=0.031) were more common among men (p=0.006) while malformations of cortical development (MCD) (p=0.031) were more common among women.
Conclusion: These findings suggest that male and female PWE exhibit distinct profiles of comorbidities and epilepsy etiologies. The higher prevalence of TBI-related epilepsy in men and the pronounced burden of psychiatric conditions and migraines in women may reflect different pathways of disease development and experience. These suggest that sex-informed approaches may lead to more effective and personalized epilepsy care.
