Childhood Absence Epilepsy- Electroclinical Profile and Prevalence of Attention-Deficit/Hyperactivity Disorder Among
Merin Eapen1, Mary Iype1, Geetha Saradakutty2
1Department of Paediatric Neurology, Government Medical College, Trivandrum, Kerala, India.
Insights
Attention-deficit/hyperactivity disorder (ADHD) is common in children with childhood absence epilepsy (CAE). Most ADHD cases were the inattentive type, with frequent cortical origin of seizures observed.
Area of Science:
- Pediatric Neurology
- Epileptology
- Neurodevelopmental Disorders
Background:
- Childhood absence epilepsy (CAE) is a common epilepsy syndrome in children.
- Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder.
- The co-occurrence of CAE and ADHD requires further investigation.
Purpose of the Study:
- To determine the prevalence of ADHD in children diagnosed with CAE.
- To characterize the electroclinical features of absence seizures in this population.
- To explore potential associations between CAE and ADHD.
Main Methods:
- Video electroencephalography (EEG) was conducted on 47 children meeting International League Against Epilepsy criteria for CAE.
- Participants underwent assessment for the presence and type of ADHD.
- Seizure data, including duration and ictal discharge characteristics, were analyzed.
Main Results:
- A high proportion of children with CAE (57%) met the criteria for ADHD.
- The inattentive subtype of ADHD was most prevalent, observed in 74% of affected children.
- Absence seizures varied in duration, with a mean of 7.1 seconds, and often exhibited a "lead in" focus (81%).
Conclusions:
- ADHD is highly prevalent in children with CAE.
- The frequent observation of a "lead in" focus in generalized ictal discharges supports a cortical origin theory for CAE seizures.
- Understanding this comorbidity can inform clinical management and research.
Background:
We aimed to find the proportion of attention-deficit/hyperactivity disorder (ADHD) among children with childhood absence epilepsy (CAE) and to describe their electroclinical features.
Methods:
Video electroencephalography (EEG) was performed on 47 children who fulfilled International League Against Epilepsy criteria for CAE. These children were also assessed for the presence of ADHD.
Results:
Of the 47 children, 27 (57%) met criteria for the diagnosis of ADHD. Majority (74%) of them had inattentive type of ADHD. Age at onset of absences ranged from three to 12 years (mean 7.2 ± 2.47). We analyzed 219 seizures (154 electroclinical and 65 electrographic). The average seizure duration was 7.1 seconds (range 1 to 38 [S.D. 5.81]). Of the 154 clinical absences, ictal discharges were less than or equal to two seconds in nine of 154 (5.8%); greater than two to less than or equal to four seconds in 33 of 154 (21.4%), and longer than 20 seconds in 11 of 154 (7%). The longest duration of ictal discharge recorded was 38 seconds, and the shortest duration was one second. The onset of ictal discharge had a "lead in" focus in 81% (177 of 219).
Conclusions:
The proportion of ADHD among children with CAE is high. A "lead in" focus of the generalized ictal discharges was observed frequently, lending support to the theory that the origin of seizure discharges in CAE is indeed cortical. The shortest ictal discharge recorded was one second.
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