engleski

Incidence of attention deficit/hyperactivity disorder in children with newly diagnosed epilepsy.

Backround: Attention deficit hyperactivity disorder (ADHD) affects 6% to 9% of school-aged children. Most authors agree that approximately one third of children with epilepsy have ADHD. The exact prevalence of ADHD in epilepsy is not known and is very varied due to methodological differences. There are still open questions whether children with epilepsy are in higher risk for developing ADHD or vice versa - the children with ADHD symptoms have more probability to develop seizure. Therefore we assessed children with newly diagnosed epilepsy in order to find prevalence of ADHD at the “ beginning” of epilepsy and to compare groups of children with ADHD (ADHD+EPI) and children with epilepsy without ADHD (EPI). Methods: we assessed 95 school-aged children with newly diagnosed epilepsy (51 males, 44 females ; age range 6-17 years, mean 10.5, SD 2.9) for evidence of ADHD. Diagnostic criteria were based on the ILAE criteria for epilepsy and Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria for ADHD. Children with mental retardation and motor disabilities were not included in the study. Results: Twenty (21%) children with ADHD+E were diagnosed, male:female ratio was 70%:30% (14 males, 6 females), while in children with EPI male:female ratio was equal (49%:50%). General seizure predominated in ADHD+EPI group (12 children - 60 %) while in group with EPI predominated partial seizure (46 children-61.3%). In both groups brain CT scan were normal. At the ADHD+EPI group various and non-specific neurological and/or behavioural complains were noticed by parents more than one month before the first seizure in 13 (65%) children while at 7 (35%) children the first seizure caused doctor attention. In the EPI group at 44 (58.6%) children first seizures was reason for doctor attention while 31 (41.4%) children had various neurological and/or behavioural complains before seizure occurrence. Conclusion: these results are in accordance with similar studies that children with epilepsy have higher prevalence of ADHD than general population. Generalised seizures were more prevalent in ADHD+EPI group which are usually not reported in more recent data. Furthermore, in ADHD+EPI group of children male:female ratio follow usual ADHD gender distribution, and more children had behavioural complains before seizure occurrence. It may represent group of children with primary ADHD who secondary developed epilepsy. Future investigations and prospective follow up is needed to determine occurrence and developing of ADHD in children where seizures i.e. epilepsy was principal symptom particularly to find out the role of seizures and antiepileptic treatment.

epilepsy; adhe; incidence

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