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Attention-deficit disorders and epilepsy in childhood: incidence, causative relations and treatment possibilities

Rami Kaufmann1, Hadassa Goldberg-Stern, Avinoam Shuper

  • 1Department of Child Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.

Journal of Child Neurology
|June 4, 2009
PubMed

Insights

Children with epilepsy show higher rates of attention-deficit hyperactivity disorder (ADHD). Methylphenidate is effective for ADHD in these children, but caution is advised if epilepsy is uncontrolled.

Area of Science:

  • Pediatric Neurology
  • Neurodevelopmental Disorders

Background:

  • Attention-deficit hyperactivity disorder (ADHD) is significantly more prevalent in children with epilepsy (20%) compared to the general pediatric population (3-7%).
  • Potential contributing factors include shared genetics, neurotransmitter dysregulation, and effects of seizures or medications.
  • Children with ADHD also exhibit a higher incidence of electroencephalography (EEG) abnormalities.

Purpose of the Study:

  • To review the relationship between epilepsy and ADHD in children.
  • To evaluate the efficacy and safety of methylphenidate treatment in children with ADHD and epilepsy.

Main Methods:

  • Literature review examining the comorbidity of ADHD and epilepsy in pediatric populations.
  • Analysis of studies on methylphenidate's efficacy and safety in children with ADHD, with and without epilepsy.

Main Results:

  • Methylphenidate demonstrates comparable efficacy (70-77%) in treating ADHD in children with and without epilepsy.
  • Methylphenidate is generally considered safe for children with epilepsy who are seizure-free.
  • Concerns exist regarding potential seizure aggravation in children with uncontrolled epilepsy treated with methylphenidate.

Conclusions:

  • Methylphenidate can be an effective treatment for ADHD in children with epilepsy.
  • Careful consideration of seizure control status is crucial before initiating methylphenidate therapy.
  • Routine EEG screening is not recommended for ADHD patients without specific indications or before methylphenidate initiation.

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