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Parent-reported symptoms of ADHD in young people with epilepsy before and two years after epilepsy surgery
Colin Reilly1, Tove Hallböök1, Gerd Viggedal1
1Dept. of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
Insights
Pediatric epilepsy surgery significantly reduced parent-reported attention-deficit/hyperactivity disorder (ADHD) symptoms two years post-operation. Seizure freedom and right-sided surgery were linked to symptom improvement in children with ADHD.
Area of Science:
- Pediatric Neurology
- Neuropsychology
- Epileptology
Background:
- Attention-deficit/hyperactivity disorder (ADHD) is frequently observed in children with epilepsy.
- Epilepsy surgery is a treatment option for refractory epilepsy, but its impact on comorbid ADHD symptoms requires investigation.
Purpose of the Study:
- To evaluate changes in parent-reported ADHD symptoms in children before and two years after undergoing epilepsy surgery.
- To identify factors associated with ADHD symptom improvement following pediatric epilepsy surgery.
Main Methods:
- A cohort of 107 children completed the Conners 10-item scale for ADHD symptoms at baseline and 2-year follow-up.
- Paired sample t-tests analyzed score changes; linear regression identified associated factors.
Main Results:
- Parent-rated ADHD symptoms significantly decreased at follow-up (p < 0.001).
- Improvements were most notable in core ADHD diagnostic criteria.
- Higher baseline ADHD scores, seizure-free status, and right-sided surgery were independently associated with symptom improvement.
Conclusions:
- Parent-reported ADHD symptoms improve 2 years after pediatric epilepsy surgery.
- Assessment for ADHD at baseline and follow-up is recommended for all children undergoing epilepsy surgery.
- Seizure control and surgical site may influence ADHD symptom trajectory post-surgery.
Abstract:
The aim was to compare parent-reported symptoms of attention-deficit/hyperactivity disorder (ADHD) before (baseline) and two years after pediatric epilepsy surgery (follow-up). The parents of 107 children who underwent epilepsy surgery completed surveys including the Conners 10-item scale at baseline and follow-up. Changes in scores between baseline and follow-up were compared using paired sample t-test. Factors associated with changes in scores were analyzed using linear regression. Features of ADHD were significantly reduced at follow-up (p < 0.001). Items with the greatest reduction were items focusing on core aspects of the diagnostic criteria for ADHD. Fewer children were in the at-risk range for ADHD on the Conners 10-item scale at follow-up but this did not reach statistical significance (49% vs. 43%; p = 0.481). Factors independently significantly associated with improvement in ADHD symptoms on multivariable analysis were higher baseline scores (p < 0.001), seizure-free status (p = 0.029), and right-sided surgery (p = 0.031). Children who undergo epilepsy surgery have a high rate of ADHD symptoms. Parent-rated symptoms of ADHD improved at 2-year follow-up after epilepsy surgery. All children undergoing epilepsy surgery should undergo assessment for ADHD at baseline and follow-up.
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