2026 American Academy of Neurology Abstract Website

Objective:

To determine how gender influences the time from diagnosis to intervention in epilepsy surgery, as well as gender-related differences in outcomes.

Background:

Despite the proven efficacy of epilepsy surgery, it is often underutilized. Studies in other fields of medicine have shown that women often experience delays in receiving specialized treatments, potentially due to differences in symptom presentation, provider bias, or systemic healthcare barriers.

Design/Methods:

A search of Embase, MEDLINE, Web of Science and PubMed (2009-present) identified studies that reported outcomes of epilepsy surgery separated by gender. Study types included RCTs, cohort studies, case-control studies, case series and systematic reviews. Studies with <10 patients or pediatric populations were excluded.

Results:

243 studies included in our analysis (total = 16,159 total patients: 7,914 women and 8,245 men).

The mean age at diagnosis was 10.9 ± 4.7 for men and 11.9 ± 5.2 for women. The average age at surgery for men was 30.1 ± 5.3 and 32.9 ± 6.0 for women. Further, the average duration of epilepsy was 18.32 ± 7.21 for men and 19.56 ± 5.97 for women.

In studies with ≤1-year follow-up, seizure freedom was achieved in 77.4 ± 1.1% of males and 73.2 ± 1.4% of females. In studies with >1-year follow-up, seizure freedom was observed in 56.6 ± 0.6% of males and 60.4 ± 0.6% of females.

Ongoing analyses aim to further delineate outcome differences by surgical type and etiology.

Conclusions:

We found that the time from diagnosis to intervention was greater in women than for men. Further, while men had better short-term outcomes, women tended to show more favorable outcomes at a longer term. However, a full conclusion can be better drawn with more comprehensive data.