Attention deficit hyperactivity disorder (ADHD) in childhood epilepsy.
Kids with epilepsy have high ADHD rates yet only methylphenidate data exist—behavioral interventions need study.
01Research in Context
What this study did
The paper is a narrative review. It pulls together studies on ADHD in children who also have epilepsy.
The author looked for any research on how common ADHD is in this group and what treatments have been tested.
What they found
Kids with epilepsy get ADHD at high rates. The only treatment papers used methylphenidate.
The review says seizure risk from the drug is still debated. It ends by asking for more studies, especially ones that use behavioral methods.
How this fits with other research
Higgins et al. (2021) extends this picture. They tracked 21 children with Down syndrome plus ADHD. Seventy-six percent improved on methylphenidate, showing the drug can work across genetic conditions.
Rasing et al. (1992) fills the behavioral gap the review wants. Two elementary students with ADHD got big attention gains when a response-cost token system was used in class.
Brackenridge et al. (2011) adds lab detail. They showed methylphenidate boosts response inhibition in typical ADHD, giving the review’s drug notes some hard evidence.
Why it matters
If you serve a child with epilepsy and attention problems, screen for ADHD early. You can offer methylphenidate, but monitor seizures closely. While you wait for more studies, try a classroom token board with response-cost rules. It costs nothing and already has positive data behind it.
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02At a glance
03Original abstract
ADHD and epilepsy common are both common childhood disorders and both can have significant negative consequences on a child's behavioural, learning, and social development. Both conditions can co-occur and population studies suggest that the prevalence of ADHD in childhood epilepsy is between 12 and 17%. The prevalence of epilepsy in ADHD is lower but it is not clear if the rate of epilepsy is higher in ADHD populations than in the general population. There is a higher occurrence of ADHD--Primarily Inattentive subtype in children with epilepsy and the reasons for this are not altogether clear but attention difficulties are very prevalent in childhood epilepsy. Seizure/epilepsy variables do not appear to be important correlates in most cases of ADHD in epilepsy although they may play a role in some cases. Individuals with both epilepsy and intellectual disability may be at higher risk for significant ADHD symptoms although screening and assessment in children with intellectual disability and epilepsy may be challenging. Children with epilepsy and ADHD are likely to be at higher risk for more negative outcomes in school and in terms of quality of life compared with children with epilepsy alone. Published studies on the treatment of ADHD in childhood epilepsy have focussed exclusively on the use of psychopharmacology and particularly methylphenidate. Although methylphenidate appears to be effective for some children with epilepsy the issue of whether it may lower seizure threshold continues to be debated. Children with epilepsy are at significant risk for ADHD and there is a need for more studies focussing on safe and efficacious interventions for symptoms of ADHD in this population.
Research in developmental disabilities, 2011 · doi:10.1016/j.ridd.2011.01.019