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Epilepsy in children with attention deficit disorder: cognitive, behavioral, and neuroanatomic indices
R O Kinney1, B A Shaywitz, S E Shaywitz
1Department of Internal Medicine, Park Nicollet Medical Center, Brooklyn Center, Minnesota.
Insights
Children with epilepsy and ADHD show lower IQs but similar learning disabilities and behaviors compared to those with ADHD alone. Brain scans were normal in both groups, indicating epilepsy impacts IQ, not LD or behavior in ADHD.
Area of Science:
- Neuroscience
- Child Psychology
- Pediatric Neurology
Background:
- Attention deficit-hyperactivity disorder (ADHD) is a common neurodevelopmental disorder.
- Epilepsy is a neurological disorder characterized by recurrent seizures.
- The co-occurrence of ADHD and epilepsy (ADHD-Sz) may present unique cognitive and behavioral challenges.
Purpose of the Study:
- To investigate the impact of epilepsy on cognitive and behavioral performance in children with ADHD.
- To compare cognitive, behavioral, and neuroimaging findings between children with ADHD-Sz and children with ADHD only.
- To test the hypothesis that epilepsy exacerbates cognitive and behavioral difficulties in ADHD.
Main Methods:
- Comparison of psychological, behavioral, and educational measures between ADHD-Sz and ADHD groups.
- Utilized the Wechsler Intelligence Scale for Children-Revised (WISC-R) for cognitive assessment.
- Cranial computed tomography (CT) scans were performed to assess for structural brain abnormalities.
Main Results:
- Children with ADHD-Sz scored significantly lower on WISC-R performance and full-scale IQ compared to the ADHD group.
- The prevalence of learning disabilities (LD) and behavioral features were similar in both ADHD-Sz and ADHD groups.
- No increased incidence of structural brain abnormalities or asymmetries was found in either group via CT scans.
Conclusions:
- Epilepsy appears to adversely affect intellectual quotient (IQ) in children with ADHD.
- Epilepsy does not seem to influence the prevalence of learning disabilities or behavioral abnormalities in children with ADHD.
- Findings support the notion of normal brain anatomy in ADHD, as indicated by CT scans.
Abstract:
Our study examined the hypothesis that if epilepsy adversely influences the cognitive and behavioral performance of children, then children with both attention deficit-hyperactivity disorder and epilepsy (ADHD-Sz) should exhibit more severe cognitive and behavioral difficulties and be more likely to demonstrate abnormalities on cranial computed tomography than ADHD children without epilepsy. We compared ADHD-Sz and ADHD patients using a variety of psychologic, behavioral, and educational measures, as well as cranial computed tomography. ADHD-Sz children scored significantly below the ADHD group on the Wechsler Intelligence Scale for Children-Revised (performance and full scale scores). In both ADHD-Sz and ADHD groups, the prevalence of learning disabilities (LD) and a variety of behavioral features were similar. Neither seizure disorder nor ADHD was associated with an increased incidence of structural abnormalities or asymmetries of the brain. These findings support the belief that epilepsy adversely affects IQ but does not appear to affect the prevalence of LD or behavioral abnormalities in ADHD children. They further support the accumulating body of data demonstrating normal brain anatomy in ADHD by computed tomography.