Sylvain Rheims1,2, Vania Herbillon2,3, Nathalie Villeneuve4, Stéphane Auvin5, Silvia Napuri6, Claude Cances7, Patrick Berquin8, Pierre Castelneau9, Sylvie Nguyen The Tich10, Frédéric Villega11, Hervé Isnard12, Rima Nabbout13, Ségolène Gaillard14, Catherine Mercier15, Behrouz Kassai14, Alexis Arzimanoglou2,3. 1. Department of Functional Neurology and Epileptology and Epilepsy Institute (IDEE), Hospices Civils de Lyon and Lyon 1 University, Lyon, France. 2. Lyon's Neuroscience Research Center, INSERM U1028/CNRS UMR 5292, Lyon, France. 3. Epilepsy, Sleep and Pediatric Neurophysiology Department, Hospices Civils de Lyon, Lyon, France. 4. Department of Pediatric Neurology, APHM, Marseille, France. 5. AP-HP, Department of Pediatric Neurology, Robert Debré Hospital, Paris, France. 6. Department of Pediatric Neurology, Rennes University Hospital, Rennes, France. 7. Department of Pediatric Neurology, Children Hospital, Toulouse, France. 8. Department of Pediatric Neurology, INSERM U1105 CURS, Amiens, France. 9. Department of Pediatric Neurology, University Hospital of Tours, Tours, France. 10. Department of Pediatric Neurology, University Hospital of Lille, Lille, France. 11. Department of Pediatric Neurology, University Hospital of Bordeaux, Bordeaux, France. 12. Lyon's University Hospital, Lyon, France. 13. Pediatric Neurology Department, Reference Center for Rare Epilepsies, Necker Hospital, Paris, France. 14. Department of Clinical Pharmacology, EPICIME-CIC 1407 Inserm, Hospices Civils de Lyon, Lyon, France. 15. Department of Biostatistics, Hospices Civils de Lyon, Lyon, France.
Abstract
OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) is commonly observed in children with epilepsy. However, factors associated with the development of ADHD and which might help to guide its therapeutic management, remain an issue of debate. METHODS: We conducted a multicenter prospective observational study that included children, aged 6-16 years, with both epilepsy and ADHD according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. After inclusion, patients entered a 12-16 week follow-up period during which they were either treated with methylphenidate or they did not receive specific ADHD treatment. ADHD was evaluated with the ADHD Rating Scale-IV. RESULTS: One hundred sixty-seven patients were included, of which 91 were seizure-free during the preinclusion baseline period. At inclusion, the ADHD Rating Scale-IV total score was 30.4 ± (standard deviation) 9.2, the inattentive subscore was 17.3 ± 4.4, and the hyperactive subscore was 13.2 ± 6.6. We did not detect any difference of ADHD Rating Scale-IV scores across patients' age or gender, age at epilepsy onset, epilepsy syndrome, seizure frequency, or number of ongoing antiepileptic drugs. Methylphenidate was initiated in 61 patients, including 55 in whom a follow-up evaluation was available. At the last follow-up, 41 patients (75%) treated with methylphenidate and 39 (42%) of those who did not received ADHD therapy demonstrated ≥25% decrease of ADHD Rating Scale-IV total score (p < 0.001). Response to methylphenidate was greater in girls but was not influenced by any epilepsy-related variables. SIGNIFICANCE: We did not detect any epilepsy-related factor associated with the severity of ADHD. Twenty-five percent of patients did not respond to methylphenidate. A better understanding of the pathologic process that underlies ADHD development in childhood epilepsy might be required to improve therapeutic strategies. Wiley Periodicals, Inc.
OBJECTIVE:Attention-deficit/hyperactivity disorder (ADHD) is commonly observed in children with epilepsy. However, factors associated with the development of ADHD and which might help to guide its therapeutic management, remain an issue of debate. METHODS: We conducted a multicenter prospective observational study that included children, aged 6-16 years, with both epilepsy and ADHD according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. After inclusion, patients entered a 12-16 week follow-up period during which they were either treated with methylphenidate or they did not receive specific ADHD treatment. ADHD was evaluated with the ADHD Rating Scale-IV. RESULTS: One hundred sixty-seven patients were included, of which 91 were seizure-free during the preinclusion baseline period. At inclusion, the ADHD Rating Scale-IV total score was 30.4 ± (standard deviation) 9.2, the inattentive subscore was 17.3 ± 4.4, and the hyperactive subscore was 13.2 ± 6.6. We did not detect any difference of ADHD Rating Scale-IV scores across patients' age or gender, age at epilepsy onset, epilepsy syndrome, seizure frequency, or number of ongoing antiepileptic drugs. Methylphenidate was initiated in 61 patients, including 55 in whom a follow-up evaluation was available. At the last follow-up, 41 patients (75%) treated with methylphenidate and 39 (42%) of those who did not received ADHD therapy demonstrated ≥25% decrease of ADHD Rating Scale-IV total score (p < 0.001). Response to methylphenidate was greater in girls but was not influenced by any epilepsy-related variables. SIGNIFICANCE: We did not detect any epilepsy-related factor associated with the severity of ADHD. Twenty-five percent of patients did not respond to methylphenidate. A better understanding of the pathologic process that underlies ADHD development in childhood epilepsy might be required to improve therapeutic strategies. Wiley Periodicals, Inc.
Authors: Isabell Brikell; Qi Chen; Ralf Kuja-Halkola; Brian M D'Onofrio; Kelsey K Wiggs; Paul Lichtenstein; Catarina Almqvist; Patrick D Quinn; Zheng Chang; Henrik Larsson Journal: Epilepsia Date: 2019-01-25 Impact factor: 5.864
Authors: Valerio Vinti; Giovanni Battista Dell'Isola; Giorgia Tascini; Elisabetta Mencaroni; Giuseppe Di Cara; Pasquale Striano; Alberto Verrotti Journal: Front Neurol Date: 2021-11-30 Impact factor: 4.003
Authors: Kelsey K Wiggs; Zheng Chang; Patrick D Quinn; Kwan Hur; Robert Gibbons; David Dunn; Isabell Brikell; Henrik Larsson; Brian M D'Onofrio Journal: Neurology Date: 2018-02-23 Impact factor: 9.910