Attention deficit hyperactivity disorder in children with epilepsy: a multicenter cross-sectional analysis in China
Gang Pan1, Ying Han2, Tian-Cheng Wang3
1Department of Neurology, Children's Hospital of Fudan University, 399 Wan Yuan Road, Minhang District, Shanghai, China.
Insights
Attention deficit hyperactivity disorder (ADHD) is common in children with epilepsy in China, but diagnosis and treatment are lacking. Further research and improved management are crucial for these children.
Area of Science:
- Neurology
- Pediatrics
- Psychiatry
Background:
- Attention deficit hyperactivity disorder (ADHD) and epilepsy comorbidity is under-addressed in China.
- A study was conducted to understand the current status of ADHD diagnosis and treatment in children with epilepsy.
Purpose of the Study:
- To investigate the prevalence of ADHD in children with epilepsy in China.
- To identify factors associated with ADHD in this population.
- To highlight the need for improved management of comorbid ADHD in children with epilepsy.
Main Methods:
- A multicenter cross-sectional survey was conducted with 395 children (aged 6-18) diagnosed with epilepsy.
- Patients were screened for ADHD, and demographic and clinical factors were compared.
- Factors analyzed included age, epilepsy onset, seizure types, EEG abnormalities, and medication status.
Main Results:
- The prevalence of ADHD was 47.8% among children with epilepsy.
- ADHD was more common in children on polytherapy, with poor seizure control, and epileptiform EEG abnormalities.
- Only 31 out of 189 children with ADHD received treatment, with the inattentive subtype being most common.
Conclusions:
- The prevalence of ADHD in children with epilepsy is higher than in the general child population.
- There is a significant gap in the diagnosis and treatment of ADHD in children with epilepsy in China.
- Increased attention to ADHD diagnosis and treatment is essential for improving the quality of life for these patients.
Background:
The diagnosis and treatment of attention deficit hyperactivity disorder (ADHD) comorbid with epilepsy have been insufficiently addressed in China. We conducted a study in China to investigate the current status, diagnosis, and treatment of ADHD in children to further our understanding of ADHD comorbid with epilepsy, strengthen its management, and improve patients' quality of life.
Methods:
We carried out a multicenter cross-sectional survey of children with epilepsy across China between March 2022 and August 2022. We screened all patients for ADHD and compared various demographic and clinical factors between children with and without ADHD, including gender, age, age at epilepsy onset, duration of epilepsy, seizure types, seizure frequency, presence of epileptiform discharges, and treatment status. Our objective was to explore any possible associations between these characteristics and the prevalence of ADHD.
Results:
Overall, 395 epilepsy patients aged 6-18 years were enrolled. The age at seizure onset and duration of epilepsy ranged from 0.1-18 to 0.5-15 years, respectively. Focal onset seizures were observed in 212 (53.6%) patients, while 293 (76.3%) patients had epileptiform interictal electroencephalogram (EEG) abnormalities. Among the 370 patients treated with anti-seizure medications, 200 (54.1%) had monotherapy. Although 189 (47.8%) patients had ADHD, only 31 received treatment for it, with the inattentive subtype being the most common. ADHD was more common in children undergoing polytherapy compared to those on monotherapy. Additionally, poor seizure control and the presence of epileptiform interictal EEG abnormalities may be associated with a higher prevalence of ADHD.
Conclusions:
While the prevalence of ADHD was higher in children with epilepsy than in normal children, the treatment rate was notably low. This highlights the need to give more importance to the diagnosis and treatment of ADHD in children with epilepsy.
