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Attention deficit hyperactivity disorder (ADHD) in children with epilepsy

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Abstract

Background

Attention deficit hyperactivity disorder (ADHD) is a common comorbidity of childhood epilepsy. ADHD symptoms in children with epilepsy have been studied since 1970s in western countries. However, relative studies are still rather limited in China.

Aims

To study the incidence rate of ADHD in children with epilepsy, and further analyze the relationship of epilepsy and ADHD in China.

Materials and methods

206 children (age 6–16) with epilepsy and 58 healthy controls underwent assessment instruments (DSM-IV ADHD, ADHD Rating Scale-IV, and SNAP-IV Rating Scale).

Results

The prevalence of comorbid ADHD was significantly higher in children with epilepsy (24.76%) than that in controls (5.17%), and inattentive subtype (ADHD-I, 14.1%) was the most prevalent. ADHD in childhood epilepsy was associated with younger age, early first onset age, and high frequency of epileptic seizures. There was no significant difference of ADHD incidence rate regarding the seizure type and abnormal electroencephalogram (EEG) discharges. The ADHD comorbidity rate in children treated with antiepileptic drugs (AEDs) (27.6%) was higher than that without AEDs therapy (14.0%); multiple AEDs were associated with a higher rate of ADHD comorbidity as compared with single AEDs. The incidence of comorbid ADHD in epileptic children treated with traditional single AEDs was significantly higher than those treated with novel single AEDs.

Conclusion

Children with epilepsy have more attention problems as compared with healthy controls. ADHD in childhood epilepsy is associated with male sex, younger age, early first onset age, high frequency of epileptic seizures, and multiple AEDs.

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References

  1. Cowan LD (2002) The epidemiology of the epilepsies in children. Ment Retard Dev Disabil Res Rev 8(3):171–181. https://doi.org/10.1002/mrdd.10035

    Article  PubMed  Google Scholar 

  2. Russ SA, Larson K, Halfon N (2012) A national profile of childhood epilepsy and seizure disorder. Pediatrics. 129(2):256–264. https://doi.org/10.1542/peds.2010-1371

    Article  PubMed  Google Scholar 

  3. Raspall-Chaure M, Neville BG, Scott RC (2008) The medical management of the epilepsies in children: conceptual and practical considerations. Lancet Neurol 7(1):57–69. https://doi.org/10.1016/S1474-4422(07)70324-1

    Article  CAS  PubMed  Google Scholar 

  4. Baker GA, Hargis E, Hsih MM, Mounfield H, Arzimanoglou A, Glauser T, Pellock J, Lund S, International Bureau for Epilepsy (2008) Perceived impact of epilepsy in teenagers and young adults: an international survey. Epilepsy Behav : E&B 12(3):395–401. https://doi.org/10.1016/j.yebeh.2007.11.001

    Article  Google Scholar 

  5. Wu KN, Lieber E, Siddarth P, Smith K, Sankar R, Caplan R (2008) Dealing with epilepsy: parents speak up. Epilepsy Behav : E&B 13(1):131–138. https://doi.org/10.1016/j.yebeh.2008.03.008

    Article  Google Scholar 

  6. Dunn DW, Austin JK, Harezlak J, Ambrosius WT (2003) ADHD and epilepsy in childhood. Dev Med Child Neurol 45(1):50–54

    Article  Google Scholar 

  7. Dunn DW, Austin JK, Perkins SM (2009) Prevalence of psychopathology in childhood epilepsy: categorical and dimensional measures. Dev Med Child Neurol 51(5):364–372. https://doi.org/10.1111/j.1469-8749.2008.03172.x

    Article  PubMed  PubMed Central  Google Scholar 

  8. Kaufmann R, Goldberg-Stern H, Shuper A (2009) Attention-deficit disorders and epilepsy in childhood: incidence, causative relations and treatment possibilities. J Child Neurol 24(6):727–733. https://doi.org/10.1177/0883073808330165

    Article  PubMed  Google Scholar 

  9. Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA (2007) The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry 164(6):942–948. https://doi.org/10.1176/ajp.2007.164.6.942

    Article  PubMed  Google Scholar 

  10. Williams J, Griebel ML, Dykman RA (1998) Neuropsychological patterns in pediatric epilepsy. Seizure. 7(3):223–228

    Article  CAS  Google Scholar 

  11. Cohen R, Senecky Y, Shuper A, Inbar D, Chodick G, Shalev V, Raz R (2013) Prevalence of epilepsy and attention-deficit hyperactivity (ADHD) disorder: a population-based study. J Child Neurol 28(1):120–123. https://doi.org/10.1177/0883073812440327

    Article  PubMed  Google Scholar 

  12. Sherman EM, Slick DJ, Connolly MB, Eyrl KL (2007) ADHD, neurological correlates and health-related quality of life in severe pediatric epilepsy. Epilepsia. 48(6):1083–1091. https://doi.org/10.1111/j.1528-1167.2007.01028.x

    Article  PubMed  Google Scholar 

  13. Holdsworth L, Whitmore K (1974) A study of children with epilepsy attending ordinary schools. I: their seizure patterns, progress and behaviour in school. Dev Med Child Neurol 16(6):746–758

    Article  CAS  Google Scholar 

  14. Sturniolo MG, Galletti F (1994) Idiopathic epilepsy and school achievement. Arch Dis Child 70(5):424–428

    Article  CAS  Google Scholar 

  15. Socanski D, Aurlien D, Herigstad A, Thomsen PH, Larsen TK (2013) Epilepsy in a large cohort of children diagnosed with attention deficit/hyperactivity disorders (ADHD). Seizure. 22(8):651–655. https://doi.org/10.1016/j.seizure.2013.04.021

    Article  PubMed  Google Scholar 

  16. Kim EH, Yum MS, Kim HW, Ko TS (2014) Attention-deficit/hyperactivity disorder and attention impairment in children with benign childhood epilepsy with centrotemporal spikes. Epilepsy Behav: E&B 37:54–58. https://doi.org/10.1016/j.yebeh.2014.05.030

    Article  Google Scholar 

  17. Semrud-Clikeman M, Wical B (1999) Components of attention in children with complex partial seizures with and without ADHD. Epilepsia. 40(2):211–215

    Article  CAS  Google Scholar 

  18. Kwong KL, Lam D, Tsui S, Ngan M, Tsang B, Lam SM (2016) Attention deficit hyperactivity disorder in adolescents with epilepsy. Pediatr Neurol 57:56–63. https://doi.org/10.1016/j.pediatrneurol.2015.12.022

    Article  PubMed  Google Scholar 

  19. Han Y, Qin J, Jiang YW, Chen J, Ji XN, Lin Q (2012) Co-morbidity of attention deficit hyperactivity disorder in children with epilepsy. Zhongguo Dang Dai Er Ke Za Zhi 14(2):89–92

    PubMed  Google Scholar 

  20. Zhang DQ, Li FH, Zhu XB, Sun RP (2014) Clinical observations on attention-deficit hyperactivity disorder (ADHD) in children with frontal lobe epilepsy. J Child Neurol 29(1):54–57. https://doi.org/10.1177/0883073812470004

    Article  PubMed  Google Scholar 

  21. Tsai FJ, Liu ST, Lee CM, Lee WT, Fan PC, Lin WS, Chiu YN, Gau SSF (2013) ADHD-related symptoms, emotional/behavioral problems, and physical conditions in Taiwanese children with epilepsy. J Formos Med Assoc= Taiwan yi zhi 112(7):396–405. https://doi.org/10.1016/j.jfma.2011.08.022

    Article  PubMed  Google Scholar 

  22. Hermann B, Jones J, Dabbs K, Allen CA, Sheth R, Fine J, McMillan A, Seidenberg M The frequency, complications and aetiology of ADHD in new onset paediatric epilepsy. Brain : A Journal of Neurology 2007;130(Pt 12):3135–3148. doi:https://doi.org/10.1093/brain/awm227.

    Article  Google Scholar 

  23. Liu ST, Tsai FJ, Lee WT, Lee CM, Fan PC, Lin WS, Chiu YN, Gau SSF (2011) Attentional processes and ADHD-related symptoms in pediatric patients with epilepsy. Epilepsy Res 93(1):53–65. https://doi.org/10.1016/j.eplepsyres.2010.10.012

    Article  PubMed  Google Scholar 

  24. Liu A, Xu Y, Yan Q, Tong L (2018) The prevalence of attention deficit/hyperactivity disorder among Chinese children and adolescents. Sci Rep 8(1):11169. https://doi.org/10.1038/s41598-018-29488-2

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Reilly CJ (2011) Attention deficit hyperactivity disorder (ADHD) in childhood epilepsy. Res Dev Disabil 32(3):883–893. https://doi.org/10.1016/j.ridd.2011.01.019

    Article  PubMed  Google Scholar 

  26. Piccinelli P, Beghi E, Borgatti R, Ferri M, Giordano L, Romeo A, Termine C, Viri M, Zucca C, Balottin U (2010) Neuropsychological and behavioural aspects in children and adolescents with idiopathic epilepsy at diagnosis and after 12 months of treatment. Seizure. 19(9):540–546. https://doi.org/10.1016/j.seizure.2010.07.014

    Article  PubMed  Google Scholar 

  27. Stores G, Hart J, Piran N (1978) Inattentiveness in schoolchildren with epilepsy. Epilepsia. 19(2):169–175

    Article  CAS  Google Scholar 

  28. Sherman EM, Brooks BL, Akdag S, Connolly MB, Wiebe S (2010) Parents report more ADHD symptoms than do teachers in children with epilepsy. Epilepsy Behav : E&B 19(3):428–435. https://doi.org/10.1016/j.yebeh.2010.08.015

    Article  Google Scholar 

  29. Koneski JA, Casella EB (2010) Attention deficit and hyperactivity disorder in people with epilepsy: diagnosis and implications to the treatment. Arq Neuropsiquiatr 68(1):107–114

    Article  Google Scholar 

  30. Ekinci O, Okuyaz C, Erdogan S, Gunes S, Ekinci N, Kalinli M et al (2017) Attention-deficit hyperactivity disorder (ADHD) in epilepsy and primary ADHD: differences in symptom dimensions and quality of life. J Child Neurol 32(14):1083–1091. https://doi.org/10.1177/0883073817737445

    Article  PubMed  Google Scholar 

  31. Richer LP, Shevell MI, Rosenblatt BR (2002) Epileptiform abnormalities in children with attention-deficit-hyperactivity disorder. Pediatr Neurol 26(2):125–129

    Article  Google Scholar 

  32. Clarke AR, Barry RJ, Bond D, McCarthy R, Selikowitz M (2002) Effects of stimulant medications on the EEG of children with attention-deficit/hyperactivity disorder. Psychopharmacology. 164(3):277–284. https://doi.org/10.1007/s00213-002-1205-0

    Article  CAS  PubMed  Google Scholar 

  33. Marston D, Besag F, Binnie CD, Fowler M (1993) Effects of transitory cognitive impairment on psychosocial functioning of children with epilepsy: a therapeutic trial. Dev Med Child Neurol 35(7):574–581

    Article  CAS  Google Scholar 

  34. Aldenkamp A, Arends J (2004) The relative influence of epileptic EEG discharges, short nonconvulsive seizures, and type of epilepsy on cognitive function. Epilepsia. 45(1):54–63

    Article  Google Scholar 

  35. Liston C, Malter Cohen M, Teslovich T, Levenson D, Casey BJ (2011) Atypical prefrontal connectivity in attention-deficit/hyperactivity disorder: pathway to disease or pathological end point? Biol Psychiatry 69(12):1168–1177. https://doi.org/10.1016/j.biopsych.2011.03.022

    Article  PubMed  Google Scholar 

  36. Mahone EM, Ranta ME, Crocetti D, O’Brien J, Kaufmann WE, Denckla MB, Mostofsky SH (2011) Comprehensive examination of frontal regions in boys and girls with attention-deficit/hyperactivity disorder. J Int Neuropsychol Soc : JINS 17(6):1047–1057. https://doi.org/10.1017/S1355617711001056

    Article  PubMed  Google Scholar 

  37. Dunn DW, Kronenberger WG (2005) Childhood epilepsy, attention problems, and ADHD: review and practical considerations. Semin Pediatr Neurol 12(4):222–228. https://doi.org/10.1016/j.spen.2005.12.004

    Article  PubMed  Google Scholar 

  38. Gallassi R, Morreale A, Di Sarro R, Marra M, Lugaresi E, Baruzzi A (1992) Cognitive effects of antiepileptic drug discontinuation. Epilepsia. 33(Suppl 6):S41–S44

    PubMed  Google Scholar 

  39. Gallassi R, Morreale A, Lorusso S, Procaccianti G, Lugaresi E, Baruzzi A (1990) Cognitive effects of valproate. Epilepsy Res 5(2):160–164

    Article  CAS  Google Scholar 

  40. Trimble MR, Thompson PJ (1984) Sodium valproate and cognitive function. Epilepsia. 25(Suppl 1):S60–S64

    Article  Google Scholar 

  41. Marciani MG, Stanzione P, Mattia D, Spanedda F, Bassetti MA, Maschio M, Bernardi G (1998) Lamotrigine add-on therapy in focal epilepsy: electroencephalographic and neuropsychological evaluation. Clin Neuropharmacol 21(1):41–47

    CAS  PubMed  Google Scholar 

  42. Meador KJ, Loring DW, Ray PG, Murro AM, King DW, Perrine KR, Vazquez BR, Kiolbasa T (2001) Differential cognitive and behavioral effects of carbamazepine and lamotrigine. Neurology. 56(9):1177–1182

    Article  CAS  Google Scholar 

  43. Aldenkamp AP, Arends J, Bootsma HP, Diepman L, Hulsman J, Lambrechts D et al (2002) Randomized double-blind parallel-group study comparing cognitive effects of a low-dose lamotrigine with valproate and placebo in healthy volunteers. Epilepsia. 43(1):19–26

    Article  CAS  Google Scholar 

  44. Hermann BP, Jones J, Sheth R, Seidenberg M (2007) Cognitive and magnetic resonance volumetric abnormalities in new-onset pediatric epilepsy. Semin Pediatr Neurol 14(4):173–180. https://doi.org/10.1016/j.spen.2007.08.003

    Article  PubMed  PubMed Central  Google Scholar 

  45. Hermann BP, Dabbs K, Becker T, Jones JE, Myers y Gutierrez A, Wendt G et al. Brain development in children with new onset epilepsy: a prospective controlled cohort investigation. Epilepsia. 2010;51(10):2038–2046. doi:https://doi.org/10.1111/j.1528-1167.2010.02563.x.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Neurology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jie Fang Avenue, Wuhan, 430030, China

    Man Wang, Qin Zhao, Huicong Kang & Suiqiang Zhu

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  1. Man Wang
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  2. Qin Zhao
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  3. Huicong Kang
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Correspondence to Suiqiang Zhu.

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Wang, M., Zhao, Q., Kang, H. et al. Attention deficit hyperactivity disorder (ADHD) in children with epilepsy. Ir J Med Sci 189, 305–313 (2020). https://doi.org/10.1007/s11845-019-02042-3

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