Comorbidade Epilepsia e TDAH

Abstract

xii Attention deficit and hyperactivity disorder (ADHD) occurs in 0.2 to 27% of all children with epilepsy. The frequency of the ADHD in patients with epilepsy, and the correlation with psychosocial aspects and behavior problems are not completely clear. The aim of this study was to verify psychosocial aspects and behavior problems in a group of patients with epilepsy and ADHD. This was a transversal study. One hundred patients were interviewed and eighty five patients (ages ranging from six to 16 years old) were selected and interviewed with a structured questionnaire. Sixty patients were diagnosed with epilepsy with presumably genetic etiology without epileptic encephalopathy (group I) and 25 patients were diagnosed with epilepsy with structural/metabolic etiology and unknown cause (group II). After clinical and EEG characterization, we used the MTA-SNAP IV Teacher and Parent Rating Scale, Vineland Adaptive Behavior Scales and the Conner's Rating Scales. ADHD occurred in 8/60 patients of group I (13%) and in 12/25 patients of group II (48%). ADHD was significantly more frequent in patients of group II than patients of group I (p = 0.02). Patients with ADHD in group II had significantly more seizures (p = 0.01), not well controlled (p = 0.02), used politherapy (p = 0.01) and lower scores (p = 0.04) in Vineland Scales (communication domain) than patients in group I. The comorbidity epilepsy-ADHD occurred in 23,5% of patients. Sporadic or well-controlled seizures and patients on monotherapy were important variables to predict lower rates of ADHD and behavioural abnormalities. xiii xv ____________________________________________________LISTA DE ANEXOS Pag. Anexo 1 Termo de consentimento livre e esclarecido 131 Anexo 2 Anamnese 135 Anexo 3 Questionário auxiliar com os critérios diagnósticos para o TDAH (DSM IV-TR, 2002) 143 Anexo 4 Escala de pontuação para pais e professores MTA-SNAP-IV 145 Anexo 5 Distribuição dos pacientes quanto ao sexo, idade, idade de início e tipo das crises epilépticas, tempo de epilepsia e classificação da epilepsia 146 Anexo 6 Distribuição dos pacientes quanto à frequência e período de controle das crises epilépticas, o eletrencefalograma atual, a terapia medicamentosa e a ressonância magnética de encéfalo 148 Anexo 7 Escala de Conners de avaliação dos pais -versão longa e revisada 150 Anexo 8 Escala de comportamento adaptativo Vineland 152