Optimizing therapy of seizures in children and adolescents with ADHD

Attention deficit hyperactivity disorder (ADHD) can coexist with epilepsy and the prevalence of ADHD in epilepsy is three to five times greater than normal. This may be an effect of the epilepsy (particularly as a secondary symptom of subtle seizures) or of the antiepileptic treatment. There is an ongoing debate about the nature of ADHD in epilepsy and especially whether successive comorbidity exists (i.e., the possibility that epilepsy lowers the threshold for developing ADHD). Treatment of comorbid ADHD may be difficult. Methylphenidate is still the treatment of choice for the condition and, although it has been shown that neither methylphenidate nor other psychostimulants provoke seizures, there is still a possibility that seizure frequency may increase in children with active epilepsy.