Attention deficit/hyperactivity disorder and interictal epileptiform discharges: It is safe to use methylphenidate?

Abstract

Despite the occurrence of IED, the use of MPH was safe during 2 years follow-up. IED predict the Sz occurrence in children with previous epilepsy, but does not necessarily suggest an increased seizure risk. A caution is warranted in order not to overestimate the significance of temporarily occurrence of IED.

ADHD in childhood epilepsy: Clinical determinants of severity and of the response to methylphenidate

“…30,31 Some studies have specifically evaluated MPH in children with epilepsy. [7][8][9][10][11][12][13] These studies, in which sample sizes were limited, ranging from 12 to 33 patients, suggested that the efficacy of MPH is similar to that described in the general population. 32 We also observed that MPH initiation was associated with a significant improvement of ADHD symptoms.…”

“…Previous studies have shown that treatment with MPH results in clinically significant decrease of ADHD symptoms in 60-80% of children with epilepsy and ADHD. [7][8][9][10][11][12][13] Although it has been suggested that efficacy of MPH might be lower in patients with idiopathic generalized epilepsy or in patients with predominantly inattentive subtype ADHD, 8 this observation has not been confirmed by others. 7,9 However the sample size of these studies, which ranged from 12 to 33 patients, [7][8][9][10][11][12][13] might have been too small to identify factors associated with response to MPH.…”

“…2,4,5 Similarly, the clinical determinants of the response to methylphenidate (MPH), the firstline pharmacologic treatment of ADHD with or without epilepsy, 6 remain unknown. 7,9 However the sample size of these studies, which ranged from 12 to 33 patients, [7][8][9][10][11][12][13] might have been too small to identify factors associated with response to MPH. [7][8][9][10][11][12][13] Although it has been suggested that efficacy of MPH might be lower in patients with idiopathic generalized epilepsy or in patients with predominantly inattentive subtype ADHD, 8 this observation has not been confirmed by others.…”

“…To address these issues, we studied the clinical determinants of severity of ADHD symptoms and of response to MPH in a multicenter observational prospective study, into which 167 children with both epilepsy and ADHD were either treated with MPH or did not receive specific ADHD treatment during a [12][13][14][15][16] week follow-up period.…”

Practical Considerations for the Assessment and Treatment of ADHD in Children with Epilepsy

“…81,82,88,89 Studies have evaluated children with both ADHD and abnormal EEGs; results in this population are mixed. 82,90,91 Hemmer and colleagues 90 reported on children with ADHD who were screened with EEG prior to initiation of medication. They identified a subset of children (15.4%) with epileptiform EEGs.…”