Childhood epilepsy and ADHD comorbidity in an Indian tertiary medical center outpatient population

Anita Choudhary,Naveen Sankhyan,Sheffali Gulati,Rajesh Sagar,Kam Sripada

doi:10.1038/s41598-018-20676-8

Abstract

This study aimed to assess the prevalence of Attention Deficit Hyperactivity Disorder (ADHD) and its characteristics and risk factors in children with epilepsy at a tertiary medical center in New Delhi. Children with active epilepsy, aged 6 to 12 years, were assessed for ADHD using DSM-IV-TR criteria. Epilepsy and psychiatric characteristics, sociodemographic indicators, and use of antiepileptic drugs were analyzed for differences between the ADHD and non-ADHD groups. Among the 73 children with epilepsy, 23% (n = 17) had comorbid ADHD, of whom 59% (n = 10) had predominantly inattentive type, 35% (n = 6) combined type, and 6% (n = 1) predominantly hyperactive-impulsive type. Lower IQ scores, epileptiform EEG activity, not attending school, and male sex were significantly associated with comorbid ADHD in children with epilepsy. Groups were similar in terms of age, socioeconomic indicators, family history of psychiatric disorders, seizure frequency in the last six months, seizure etiology, and seizure type. Epilepsy is a common pediatric neurological condition with frequent psychiatric comorbidities, including ADHD. Specialists should collaborate to optimize treatment for children with epilepsy and ADHD, especially for families in developing countries where the burden of disease can be great.

Highlights

Attention Deficit Hyperactivity Disorder (ADHD) is a common comorbidity experienced by children with epilepsy, and is associated with problems in social functioning, learning, quality of life, and academic attainment[1,2,3,4]
This study aimed to quantify the prevalence of ADHD and its subtypes among children with epilepsy at an urban tertiary medical center
100 patients were enrolled in a general epilepsy and psychopathology cohort whose findings have been previously reported[13], and those aged 6 to 12 (n = 73) were included in this ADHD study

Summary

Introduction

Attention Deficit Hyperactivity Disorder (ADHD) is a common comorbidity experienced by children with epilepsy, and is associated with problems in social functioning, learning, quality of life, and academic attainment[1,2,3,4]. Several factors may contribute to this comorbidity[5,6], including underlying brain pathology, chronic effects of seizures, epileptiform brain activity as seen on electroencephalogram (EEG), and effects of antiepileptic drugs[7] (AEDs). This comorbidity presents challenges to clinicians in determining a medication regimen and treatment plan[8]. Prevalence estimates of behavioral comorbidities in epileptic children and adolescents in India ranges from 40 to 54%4,13,14. This study aimed to quantify the prevalence of ADHD and its subtypes among children with epilepsy at an urban tertiary medical center. Academic and sociodemographic factors, and use of AEDs were compared to describe the clinical profile of this pediatric group

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Discussion

Conclusion