Attention deficit hyperactivity disorder in children with epilepsy
Pasquale Parisi1, Romina Moavero, Alberto Verrotti
1Department of Pediatrics - La Sapienza University of Rome, Rome, Italy.
Insights
Attention deficit hyperactivity disorder (ADHD) is more common in children with epilepsy. Treatment with psychotropic drugs is generally safe and can improve cognitive and behavioral outcomes.
Area of Science:
- Pediatric Neurology
- Neurodevelopmental Disorders
- Epilepsy Research
Background:
- Attention deficit hyperactivity disorder (ADHD) is more prevalent in children with epilepsy compared to the general pediatric population.
- Comorbidity may stem from shared neuropathology, chronic seizure effects, epileptiform discharges, and antiepileptic drug (AED) side effects.
- ADHD symptoms can precede seizure onset in some cases and are more frequent in specific epilepsy types like frontal lobe epilepsy, childhood absence epilepsy, and Rolandic epilepsy.
Purpose of the Study:
- To explore the factors contributing to ADHD and epilepsy comorbidity in children.
- To discuss the challenges and strategies for managing ADHD symptoms in epileptic children.
- To evaluate the safety and efficacy of psychotropic medications in this population.
Main Methods:
- Review of existing literature on ADHD and epilepsy comorbidity.
- Analysis of contributing factors including neurological, electrophysiological, and pharmacological influences.
- Discussion of clinical management approaches and treatment outcomes.
Main Results:
- ADHD is a frequent comorbidity in pediatric epilepsy, influenced by various underlying factors.
- Specific epilepsy syndromes show a higher association with ADHD symptoms.
- Psychotropic medication initiation is feasible and generally safe for epileptic children with ADHD symptoms, often requiring combination therapy for optimal results.
Conclusions:
- The comorbidity of ADHD and epilepsy in children is multifactorial and requires careful clinical consideration.
- Management strategies should address both conditions to improve long-term cognitive and behavioral prognosis.
- Psychotropic drug treatment can be safely implemented in most cases, potentially improving outcomes for affected children.
Abstract:
Attention deficit hyperactivity disorder (ADHD) is more frequent in children with epilepsy than in general pediatric population. Several factors may contribute to this comorbidity, including the underlying brain pathology, the chronic effects of seizures and of the epileptiform EEG discharges, and the effects of antiepileptic drugs. Symptoms of ADHD are more common in some specific types of epilepsies, such as frontal lobe epilepsy, childhood absence epilepsy and Rolandic epilepsy, and may antedate seizure onset in a significant proportion of cases. In epileptic children with symptoms of ADHD, treatment might become a challenge for child neurologists, who are forced to prescribe drugs combinations, to improve the long-term cognitive and behavioral prognosis. Treatment with psychotropic drugs can be initiated safely in most children with epilepsy and ADHD symptoms.
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