Clinical and neuropsychological assessment of attention and ADHD comorbidity in a sample of children and adolescents with idiopathic epilepsy

Abstract

Children with epilepsy present significant problems concerning attention and comorbidity with attention deficit hyperactivity disorder (ADHD). Objective: To determine the prevalence of attention complaints, ADHD diagnosis and attention profile in a sample of children and adolescents with idiopathic epilepsy. Method: 36 children and adolescents with idiopathic epilepsy and 37 genre and age matched healthy controls underwent several procedures to diagnose their neuropsychological profile and comorbidity with ADHD. Results: The prevalence of ADHD was higher in patients with epilepsy [x 2 = 4.1, p = 0.043, 6 (16.7%) vs 1 (2.7%)], with worse results in attention related WISC items and factors in patients with epilepsy comparing to the controls, but not between patients with and without ADHD. Clinical characteristics did not influence those results. Conclusion: This study found a greater prevalence of problems wih attention in pediatric patients with idiopathic epilepsy, but not a distinct profile between those with or without ADHD.Keywords: epilepsy, attention, ADHD, childhood, adolescence. RESUMOCrianças com epilepsia podem apresentar problemas de atenção e comorbidade com transtorno de atenção e hiperatividade (TDAH). Objetivo: Determinar a prevalência de queixas de atenção, diagnóstico de TDAH e perfil atentivo em uma amostra de crianças e adolescentes com epilepsia idiopática. Método: 36 crianças e adolescentes com epilepsia idiopática e 37 controles saudáveis foram submetidos a vários procedimentos para diagnosticar perfil neuropsicológico e comorbidade com TDAH. Resultados: A prevalência de TDAH foi maior em pacientes com epilepsia [x 2 = 4,1, p = 0,043, 6 ( 16,7%) vs 1 (2,7%)] , que também apresentaram piores resultados em itens e fatores dependentes de atenção do WISC. Não foram observadas diferenças entre pacientes com e sem TDAH. As características clínicas não influenciaram resultados. Conclusão: Este estudo encontrou uma maior prevalência de problemas com atenção em pacientes pediátricos com epilepsia idiopática , mas não um perfil distinto entre aqueles com ou sem TDAH.Palavras-chave: epilepsia, atenção, TDAH, infância, adolescência.Children and adolescents with epilepsy have more problems with attention, and therefore, more behavioral complaints and learning deficits 1,2 . In addition to epilepsy-related variables, many comorbidities contribute to attention deficits in this population, such as learning and psychiatric (mood and anxiety) disorders and attention deficit hyperactivity disorder (ADHD) 1 . ADHD is the most prevalent neuropsychiatric disorder among children in school age (5% in Brazilian sutides) 3,4 . The prevalence of ADHD is higher in children with epilepsy, ranging from 28.6% to 37.7% 1,5,6 . Some authors argue that this prevalence must be equal of the general population (3%-5%) when only patients with normal intelligence and controlled seizures were analyzed 7 . Even though, recent

Attention Deficit Disorder in the Neuropediatric Outpatient Clinic. Our Current Experience with Children Over Seven and a Half Years Old

“…ADD/ADHD figures among children with epilepsy are between 16.7% and 50%, influenced by antiepileptic drugs, the type of epilepsy and the underlying brain impairment [12,13]. ADD/ADHD is present in 31% of our cases monitored for epilepsy; the incidence is lower (14%), showing that the worst cases of epilepsy are monitored for longer and are more frequently accompanied by ADD/ADHD than epilepsies that evolve more favorably.…”

Comparison of cognitive function, socioeconomic level, and the health-related quality of life between epileptic patients with attention deficit hyperactivity disorder and without

“…Furthermore, Hermann et al found no differences between the group of epilepsy and the group of ADHD with epilepsy in terms of the number of anticonvulsant drugs [44]. Regarding seizure frequency, many previous studies have found no correlation of seizure frequency in the studied groups [31,51,52].…”

“…Regarding the type of seizures, the higher proportion had a generalized type of epilepsy in both groups. Considerable research has examined whether distinct seizure types were associated with a higher risk of ADHD and epilepsy and has found no association [31,51,52]. ILAE has also concluded that specific seizure types are not anticipated higher risk of ADHD in epilepsy [44,45,50,53].…”

“…That was further confirmed by the CPRS subscales, as the group of ADHD with EEG changes similar to the group of ADHD with epilepsy had a highly elevated clinical rating response in all subscales relative to the group of ADHD without EEG changes. These variations in ADHD subtypes could be attributed to the characteristics of the methodology of different studies [51].…”

Concepts, Beliefs, and Traditional Treatment for Childhood Seizures in a Quilombola Community in Northeastern Brazil: Analysis by the Discourse of the Collective Speech

“…Symptoms related to seizures are potentially frightening and inherently dramatic for family and friends. In the long term, they can represent epilepsy—severe neurological damage—, associated psychiatric disorders and relevant impact on the quality of life, causing withdrawal and social isolation, strengthening the stigma that permeates seizures [ 2 ].…”