Abstracts

Rationale: Repetitive seizures may be associated with progressive neuronal damage measurable by quantitative MRI. We investigated whether gender is a risk factor for this damage. Methods: Sixty patients with refractory TLE (28 males, 32 females) and 54 healthly controls (28 males, 26 females) were compared by quantitative MRI methods. Results: Male patients had ipsilateral hemicranial volume loss of 12%, confidence interval (CI) 16%-8%, and contralateral volume loss of 7% (CI: 11%-3%) compared to male controls (p? 0.004, ANOVA). Female patients were 4% (CI: 8%-0.3%; p=0.04) smaller than controls in the ipsilateral hemicranium, and not different contralaterally. The patient-to-control difference was larger in males than females for the ipsilateral and contralateral hemicranial volume (p?0.02). In males, 14% of the ipsilateral (F=4.7, p=0.004) and 16% of the contralateral (F=5.1, p=0.03) hemicranial volume loss could be attributed to generalized tonic clonic seizures. Patients, compared to controls, had in average a 30% smaller ipsilateral and a 6% smaller contralateral hippocampus. Discussion: Males with TLE have more brain atrophy than females with TLE. Seizure frequency is a factor contributing to reduced brain volumes in males but not in females. Males, therefore, may be more vulnerable to seizure associated brain abnormalities.