Attention deficit hyperactivity disorder in children with epilepsy

Objective: To establish the prevalence of attention deficit hyperactivity disorder in epileptic children and their siblings and to evaluate the factors that explain this association. Methods: Observational analytical study with 185 children with epilepsy and 63 siblings aged 6 – 18 years selected from different epilepsy clinics. They were evaluated on the basis of the DSM IV for ADHD checklist and the Behavioral Assessment System for Children (BASC) for parents and teachers. Results: Prevalence of ADHD was 39.3% in children with epilepsy and 14.4% in their siblings. Combined sub-type was the most frequent in both groups. 53.3% of the patients had focal seizures and the most frequent diagnosis was partial epilepsy (67.8%); 62% of children were on antiepileptic treatment and 52% had no seizures. There was no correlation between type or frequency of seizures, epileptic syndrome, use, type or number of drugs or persistence of seizures and the presence of ADHD. Younger patients have a higher risk of presenting the disorder compared to older children (OR=2.02 IC 95%=1.08 – 3.70). Some Psychiatric symptoms like anxiety, depression, behaviour disturbances, atipicality etc. are related to the presence of ADHD. In contrast, children with good performance at school and with good social abilities had less risk (OR=.382 IC 95%= .20 – .74; OR=.35 IC 95%=.14–.89). Conclusion: There is an important association between the presence of epilepsy and attention deficit hyperactivity disorder. However, the absence of correlation with most of the variables related to the epilepsy, the presence of psychiatric comorbidities, the high prevalence of ADHD in siblings and the low risk that exists with a good academic performance or with good social skills suggests that there are other related environmental or genetic factors.