Epileptiform abnormalities in children with attention-deficit-hyperactivity disorder

Area of Science:

• Pediatric Neurology
• Neurodevelopmental Disorders
• Clinical Neurophysiology

Background:

• Attention-deficit-hyperactivity disorder (ADHD) is a common neurodevelopmental disorder.
• Epileptiform abnormalities on electroencephalogram (EEG) are a concern in pediatric populations.
• The relationship between ADHD and epileptiform abnormalities requires further investigation.

Purpose of the Study:

• To compare the prevalence of epileptiform abnormalities in children with ADHD versus a control group.
• To assess the diagnostic utility of routine EEG for comorbid seizure disorders in children with ADHD.

Main Methods:

• Retrospective review of medical records for 655 children aged 5-16 referred for hyperactivity or behavioral issues.
• EEG data analyzed for epileptiform abnormalities in 347 children meeting ADHD criteria.
• Comparison with historical data from 3,726 normal school-aged children.

Main Results:

• A significantly higher prevalence of epileptiform abnormalities (6.1%) was found in children with ADHD compared to normal children (3.5%, P < 0.025).
• Activation procedures (hyperventilation, photic stimulation) elicited abnormalities in six ADHD patients.
• Only three of 21 children with epileptiform abnormalities developed a seizure disorder.

Conclusions:

• Children with ADHD exhibit a greater prevalence of epileptiform abnormalities when activation procedures are employed.
• Routine EEG has limited clinical utility for diagnosing comorbid seizure disorders in children with ADHD.