Attention deficit disorder and epilepsy

Area of Science:

• Neurology
• Pediatrics
• Child Psychiatry

Background:

• Patients with epilepsy show increased behavioral disturbances, including hyperactivity and inattention.
• These issues are documented via observer questionnaires, behavior rating scales, neuropsychological tests, and continuous performance tests.
• Differential diagnosis is crucial, considering subclinical seizures, learning disabilities, sleep disturbances, and attention deficit disorder.

Purpose of the Study:

• To review the factors contributing to hyperactivity and inattention in children with epilepsy.
• To discuss the role of electroencephalographic monitoring in diagnosis.
• To evaluate the safety and efficacy of antiepileptic drugs and ADHD treatments in this population.

Main Methods:

• Literature review of studies on epilepsy, behavioral disturbances, and attention deficits.
• Analysis of diagnostic methods, including electroencephalographic monitoring.
• Assessment of medication effects on attention and behavior.

Main Results:

• Electroencephalographic monitoring aids in distinguishing behavioral inattention from seizures and assessing subclinical seizure activity.
• Most antiepileptic drugs are safe for attention and behavior at therapeutic doses, except phenobarbital, gabapentin, and topiramate.
• Lamotrigine and carbamazepine may offer beneficial effects on cognition.

Conclusions:

• Stimulant medications, excluding bupropion, appear safe and effective for attention deficit disorder in children with epilepsy.
• Atomoxetine has shown no adverse effects in children with epilepsy.
• Comprehensive evaluation is necessary to address behavioral disturbances in children with epilepsy.