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Stimulant therapy and seizure risk in children with ADHD

S A Hemmer1, J F Pasternak, S G Zecker

  • 1Department of Pediatrics, Division of Neurology, Evanston Hospital, IL 60201, USA.

Pediatric Neurology
|March 29, 2001
PubMed

Insights

Children with attention-deficit-hyperactivity disorder (ADHD) and normal EEGs have minimal seizure risk with stimulant treatment. However, those with epileptiform abnormalities on EEG face a considerable seizure risk, independent of stimulant use.

Area of Science:

  • Pediatric Neurology
  • Neurophysiology

Background:

  • Stimulant medications are common ADHD treatments, but concerns exist regarding their impact on seizure risk.
  • Existing research primarily addresses well-controlled epilepsy, with limited data on seizure risk in children with ADHD without epilepsy receiving stimulants.

Purpose of the Study:

  • To investigate the seizure risk associated with stimulant treatment in children with uncomplicated ADHD, particularly in relation to EEG findings.
  • To determine if electroencephalogram (EEG) abnormalities predict seizure occurrence in this population.

Main Methods:

  • Electroencephalograms (EEGs) were performed on 234 children diagnosed with ADHD.
  • Patients were categorized based on EEG results (normal, nonepileptiform, or epileptiform abnormalities, including rolandic spikes).
  • Seizure occurrence was tracked in relation to stimulant therapy and EEG findings.

Main Results:

  • 15.4% of children exhibited epileptiform abnormalities on EEG; rolandic spikes were common.
  • Seizures occurred in 0.6% of patients with normal EEGs and 10% of those with epileptiform EEGs, exclusively in the stimulant-treated group.
  • Children with rolandic spikes had a 16.7% seizure incidence.

Conclusions:

  • A normal EEG suggests minimal seizure risk for children with ADHD undergoing stimulant treatment.
  • Epileptiform EEG abnormalities in neurologically normal children with ADHD indicate a significant risk of seizures.
  • The identified seizure risk appears associated with underlying EEG abnormalities rather than solely stimulant use.

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