ADHD in idiopathic epilepsy

Abstract

ADHD is three to five times more common in people with epilepsy than in the normal population 1,2 . It occurs in 14-31% of children with epilepsy 3,4 . It seems that the severity of epilepsy enhances the predisposition for having ADHD, since comorbidity is described in both benign and refractory childhood epilepsy 1,[5][6][7] . Inattentive ADHD is appointed as the most common subtype in epileptic patients 4,[6][7][8] .Etiology, duration of epilepsy, seizure frequency, seizure control, and the use of antiepileptic drugs are important varia bles related to neuropsychological and behavioural problems in patients with epilepsy and ADHD. It seems that patients with idiopathic epilepsy presenting with few seizures or who are seizure-free with monotherapy have a low frequency of neuropsychological and behavioral problems [8][9][10][11][12] . Epileptiform discharges, particularly during the active phase of the epilepsy, are also an important variable when neuropsychology and behavior are concerned 6,8,11 .The correlation between the variables of epilepsy and ADHD has not yet been fully elucidated. This study aims to verify the occurrence of ADHD symptoms in a group of patients with idiopathic epilepsy and the relationship between clinical variables, electroencephalogram (EEG), treatment, and psychosocial and behavioral changes. MetHoDsThis is a cross-sectional study. We interviewed 60 patients who were diagnosed with idiopathic epilepsy according to the ILAE criteria 13 . Patients were followed at the Childhood AbstrActOur aim was to clarify the correlation of attention deficit hyperactivity disorder (ADHD) with epilepsy and behavior problems. This was a crosssectional study. Sixty children with idiopathic epilepsy were interviewed using the MTA-SNAP IV Teacher and Parent Rating Scale, Vineland Adaptive Behavior Scales and Conners' Rating Scales. We used the chi-square test to analyze the correlation of epilepsy variables in patients with and without ADHD with a significance level of 0.05. Eight patients had ADHD symptoms (13%), seven had the inattentive ADHD subtype and only three had behavioral problems. When epileptic patients with and without ADHD symptoms were compared we found no significant difference in regard to epilepsy variables. All patients were controlled and 43% were either without AED or undergoing withdrawal. Our study revealed a low comorbidity of ADHD symptoms and epilepsy due to low interference of seizures and drug treatment on the comorbid condition.Keywords: epilepsy, ADHD, childhood, psychosocial aspects, behavior. resuMo Nosso objetivo foi clarificar a correlação entre transtorno do déficit de atenção (TDAH) com epilepsia e problemas comportamentais. Este foi um estudo transversal. Sessenta crianças com epilepsia idiopática foram entrevistadas com a Escala para Pais e Professores MTA-SNAP IV, Escala de Comportamento Adaptativo Vineland e Escala Conners. Utilizamos o teste do qui-quadrado para analisar a correlação das variá-veis de epilepsia em pacientes com e sem TDAH com um nível de significâ...

Speed and complexity characterize attention problems in children with localization‐related epilepsy

“…The nature of attention difficulties in children with epilepsy has not been fully characterized, yet the diagnostic difference of less impulsivity and hyperactivity suggests that children with comorbid epilepsy and ADHD may have a unique cognitive profile. Most previous studies are limited by how they assessed attention—either by parent/teacher reports or with a continuous performance task . This study addresses a gap in the literature by characterizing attention problems in children with epilepsy with a measure that assesses several components of attention.…”

“…Most previous studies are limited by how they assessed attention-either by parent/teacher reports or with a continuous performance task. 6,7,10,[13][14][15][16][17] This study addresses a gap in the literature by characterizing attention problems in children with epilepsy with a measure that assesses several components of attention. The Test of Everyday Attention for Children (TEA-Ch) was developed to measure functionally separable attentional systems in children using visual and auditory sensory stimuli in both simple and complex attention tasks (Table 1) 18 and has been used in several studies of children with ADHD.…”

TDAH nas epilepsias: prevalência e fatores de risco

“…A baixa prevalência de TDAH apontada por G. H. Kim et al (2012) pode estar relacionada à exclusão da casuística de crianças na fase ativa da doença e que apresentaram crises nos últimos três meses que antecederam o diagnóstico de TDAH. Nos demais estudos, nos quais a frequência das crises não foi considerada como um fator de risco para os sintomas de TDAH (Duran et al, 2014;G. H. Kim et al, 2012;E.…”

“…Dentre os 15 artigos analisados, somente 8 se propuseram a identificar o tipo de apresentação de TDAH. A apresentação predominantemente desatenta foi a mais prevalente nos estudos de Berl et al (2015), Chidi et al (2014) e Duran et al (2014), a apresentação combinada foi a mais prevalente na casuística de G. H. Kim et al (2012), Kwong et al (2016), Tanabe, Kashiwagi, Shimakawa, Tamai, & Wakamiya (2014) e Zhang et al (2014), e Costa, Oliveira, Gomes, & Maia Filho (2015 não observaram diferença significante entre essas apresentações. Três variáveis podem ter contribuído para a maior ocorrência de uma das apresentações: o gênero predominante na casuística, o controle de crises e a presença de outras comorbidades.…”

Nonlinear EEG biomarker profiles for autism and absence epilepsy

“…The hallmark of an absence seizure is an abrupt loss of consciousness, usually without motor impairment that may last a few seconds to half a minute [24]. Because of the lack of overt seizures, the symptoms of AE are sometimes initially misdiagnosed as an attention deficit problem (ADHD) [25][26][27]. Absence seizures in children with ASD may not be detected because the seizure symptomology may be similar to behavioral symptoms of autism [7].…”