Sex-based electroclinical differences and prognostic factors in epilepsy with eyelid myoclonia.
Emanuele Cerulli IrelliEnrico CocchiGeorgia RamantaniAlessandra MoranoAntonella RivaRoberto H CaraballoLoretta GiulianoTülay YilmazEleni PanagiotakakiFrancesca Felicia OpertoBeatriz Gonzalez GiraldezSimona BalestriniKatri SilvennoinenSara CasciatoMarion ComajuanFrancesco FortunatoAnna T GiallonardoRimma GamirovaAntonietta CoppolaGiancarlo Di GennaroAngelo LabateVito SofiaGerhard J KlugerAntonio GambardellaDorothee Kasteleijn-Nolst TreniteBetul BaykanSanjay M SisodiyaAlexis A ArzimanoglouPasquale StrianoCarlo Di Bonaventuranull nullPublished in: Epilepsia (2023)
Although a striking female preponderance has been consistently reported in epilepsy with eyelid myoclonia (EEM), no study has specifically explored the variability of clinical presentation according to sex in this syndrome. Here, we aimed to investigate sex-specific electroclinical differences and prognostic determinants in EEM. Data from 267 EEM patients were retrospectively analyzed by the EEM study group, and a dedicated multivariable logistic regression analysis was developed separately for each sex. We found that females with EEM showed a significantly higher rate of persistence of photosensitivity and eye closure sensitivity at the last visit, along with a higher prevalence of migraine with aura, whereas males with EEM presented a higher rate of borderline intellectual functioning/intellectual disability. In female patients, multivariable logistic regression analysis revealed age at epilepsy onset, eyelid myoclonia status epilepticus, psychiatric comorbidities and catamenial seizures as significant predictors of drug resistance. In male patients, a history of febrile seizures was the only predictor of drug resistance. Hence, our study reveals sex-specific differences both in terms of electroclinical features and prognostic factors. Our findings support the importance of a sex-based personalized approach in epilepsy care and research, especially in genetic generalized epilepsies.
Keyphrases
- prognostic factors
- end stage renal disease
- chronic kidney disease
- ejection fraction
- intellectual disability
- newly diagnosed
- healthcare
- autism spectrum disorder
- peritoneal dialysis
- gene expression
- palliative care
- dna methylation
- patient reported outcomes
- quality improvement
- health insurance
- deep learning
- affordable care act