The epilepsies are common neurologic disorders characterized by spontaneous recurrent seizures. Boys, girls, men, and women of all ages are affected by epilepsy and, in many cases, by associated comorbidities as well. The primary courses of treatment are pharmacological, dietary, and/or surgical, depending on several factors, including the areas of the brain affected and the severity of the epilepsy. There is a growing appreciation that sex differences in underlying brain function and in the neurobiology of epilepsy are important factors that should be accounted for in the design and development of new therapies. In this review, we discuss the current knowledge on sex differences in epilepsy and associated comorbidities, with emphasis on those aspects most informative for the development of new pharmacotherapies. Particular focus is placed on sex differences in the prevalence and presentation of various focal and generalized epilepsies; psychiatric, cognitive, and physiologic comorbidities; catamenial epilepsy in women; sex differences in brain development; the neural actions of sex and stress hormones and their metabolites; and cellular mechanisms, including brain-derived neurotrophic factor signaling and neuronal-glial interactions. Further attention placed on potential sex differences in epilepsies, comorbidities, and drug effects will enhance therapeutic options and efficacy for all patients with epilepsy.

中文翻译：

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癫痫和相关合并症的性别差异：对药物治疗的使用和开发的影响。

癫痫是常见的神经系统疾病，其特征是自发性反复发作。所有年龄段的男孩、女孩、男人和女人都会受到癫痫的影响，在许多情况下，还会受到相关的合并症的影响。主要的治疗过程是药物、饮食和/或手术，这取决于几个因素，包括受影响的大脑区域和癫痫的严重程度。越来越多的人认识到，潜在大脑功能和癫痫神经生物学的性别差异是设计和开发新疗法时应考虑的重要因素。在这篇综述中，我们讨论了当前关于癫痫和相关合并症的性别差异的知识，重点是那些对开发新药物疗法最有用的方面。特别关注各种局灶性和全身性癫痫的患病率和表现的性别差异；精神、认知和生理合并症；女性月经性癫痫；大脑发育的性别差异；性激素和压力激素及其代谢物的神经作用；和细胞机制，包括脑源性神经营养因子信号传导和神经元-神经胶质相互作用。进一步关注癫痫、合并症和药物作用的潜在性别差异，将增强所有癫痫患者的治疗选择和疗效。性激素和压力激素及其代谢物的神经作用；和细胞机制，包括脑源性神经营养因子信号传导和神经元-神经胶质相互作用。进一步关注癫痫、合并症和药物作用的潜在性别差异，将增强所有癫痫患者的治疗选择和疗效。性激素和压力激素及其代谢物的神经作用；和细胞机制，包括脑源性神经营养因子信号传导和神经元-神经胶质相互作用。进一步关注癫痫、合并症和药物作用的潜在性别差异，将增强所有癫痫患者的治疗选择和疗效。