Related Experiment Video
Updated: May 14, 2026
Using Brain Activation (nir-HEG/Q-EEG) and Execution Measures (CPTs) in a ADHD Assessment Protocol
Published on: April 1, 2018
[Assessment of ADHD with EEG]
Trond Sand1, Noralv Breivik, Anita Herigstad
1Avdeling for nevrologi og klinisk nevrofysiologi, St. Olavs hospital, Norway. trond.sand@ntnu.no
Insights
Children with ADHD may show increased epileptiform EEG activity. While QEEG shows differences, it is not recommended as a standalone diagnostic marker for ADHD or epilepsy.
Area of Science:
- Neuroscience
- Pediatrics
- Clinical Electrophysiology
Context:
- Attention-Deficit/Hyperactivity Disorder (ADHD) and epilepsy frequently co-occur in children.
- Understanding the role of electroencephalography (EEG) in diagnosing comorbid epilepsy in children with ADHD is crucial.
Purpose:
- To review the use of EEG in children with ADHD, focusing on the diagnosis of comorbid epilepsy.
- To evaluate the significance of epileptiform EEG activity and quantitative EEG (QEEG) findings in ADHD.
Summary:
- Children with ADHD, even without epilepsy, exhibit a moderately elevated prevalence of epileptiform EEG activity compared to healthy controls.
- QEEG studies indicate higher slow theta activity and theta/beta ratios in children with ADHD, but these findings are considered artifact-prone and non-specific.
- The clinical significance of epileptiform EEG activity in ADHD without seizures remains uncertain, and QEEG is not recommended as a standalone diagnostic tool.
Impact:
- Suggests that seizure symptoms, sleep disturbances, or behavioral/cognitive changes in children with ADHD warrant neurological assessment including EEG.
- Highlights the limitations of QEEG in diagnosing ADHD and comorbid epilepsy, emphasizing the need for specialist interpretation of EEG findings.
Background:
Many children with ADHD develop epilepsy, and approximately 20% of children with epilepsy also have ADHD. In this article we discuss the use of EEG in connection with ADHD in children, with emphasis on the diagnosis of comorbid epilepsy.
Method:
The article is based on a literature search in PubMed, personal literature archives and the authors' own experience with the use of EEG, treatment of epilepsy and the diagnosis and treatment of ADHD in children and adolescents.
Results:
A moderately elevated prevalence of epileptiform EEG activity is described in children with ADHD without epilepsy compared with healthy children, during both wakefulness and sleep. Selected material and a lack of controlled blinded studies probably explain much of this difference. The significance of epileptiform EEG activity in children with ADHD without seizures is uncertain. Evaluating the extent to which EEG findings may explain the symptoms and whether anti-epileptic drugs should be tried is a specialist task. In many studies, spectral analysis of the frequency content of the EEG (QEEG) has shown higher slow theta activity and a higher theta/beta ratio in children with ADHD.
Interpretation:
Seizure symptoms, disturbed sleep quality, significant changes in behaviour or regression of cognitive ability in children with ADHD should lead to paediatric neurological assessment with EEG and possibly a 24-hour EEG. In our view, the QEEG variables are artifact-prone and biologically unspecific. We therefore do not recommend the use of QEEG as a stand-alone diagnostic marker.
