Clinical Features And Related Risk Factors Of Attention Deficit/Hyperactivity Disorder In Children With Epilepsy

Part one The clinical features of attention-deficit/hyperactivity disorder of in children with epilepsy.Objective1. To estimate the prevalence of attention-deficit/hyperactivity disorder (ADHD) in children with epilepsy.2. To research the characteristics of ADHD in children with epilepsy.Method1. In accordance with the pre-defined inclusion and exclusion criteria, we collected children with epilepsy from Department of Neurology in Tongji hospital of Tongji medical college of Huazhong University of Science and Technology during July2013to Feburary2014, a total of206children aged6-16years old were enrolled. We also collected a total of58normal children in the same area as the control group.2.We collected the general information of all children and finished the questionnaires, then completed the diagnosis of ADHD.Result1.The ADHD subtype distribution in children with epilepsy and in control group: According to ADHD DSM-IV diagnostic questionnaire,3children met the diagnostic criteria of ADHD in all the58children in control group,1(33.3%,1/3) predominately inattentive type(ADHD-I),0predominately hyperactive/impulsive type (ADHD-HI),2(66.7%,2/3) predominately combined type(ADHD-C). In all the children with epilepsy, according to ADHD DSM-IV diagnostic questionnaire,51patients met the diagnostic criteria of ADHD,29(56.9%,29/51) ADHD-I,7(13.7%,7/51) ADHD-HI,15(29.4%,15/51) ADHD-C.2.Prevalence of ADHD in children with epilepsy and in control group:According to ADHD DSM-IV diagnostic questionnaire,3(5.2%) children met the diagnostic criteria of ADHD in all the58children in control group,1(1/58,1.7%) ADHD-I,2(2/58,3.4%) ADHD-C. In all the206children with epilepsy, according to ADHD DSM-IV diagnostic questionnaire,51(24.8%) patients met the diagnostic criteria of ADHD,29(29/206,14.1%) ADHD-I,7(7/206,3.4%) ADHD-HI,15(15/206,7.3%) ADHD-C; then, according to ADHD-Rating Scale-IV and SPAN-IV Rating Scale,42(20.4%) children were considered as suspicious ADHD patients in children with epilepsy.In total, the definite ADHD children and suspicious ADHD children were93(45.1%) in children with epilepsy.3. In children with epilepsy, the higher prevalence of ADHD in male than female(P<0.05), and the higher prevalence of ADHD in school age patient (P<0.05).ConclusionThe prevalence of ADHD in children with epilepsy was much higher than that in normal children. The characteristics of ADHD in epileptic children was mainly ADHD-I, and occured mainly in male or school age children with epilepsy. Part two The related risk factors that may contribute to attention-deficit/hyperactivity disorder of in children with epilepsy.ObjectiveTo analyze the epilepsy-related factors such as seizure type, onset age, duration, frequency, electroencephalograph(EEG), antiepileptic drugs (AEDs) and multiple factors that may contribute to ADHD in children with epilepsy, then research the related risk factors.Method1. In accordance with the pre-defined inclusion and exclusion criteria, we collected children with epilepsy from Department of Neurology in Tongji hospital of Tongji medical college of Huazhong University of Science and Technology during July2013to Feburary2014, a total of206children aged6-16years old were enrolled.2. We Collected the clinical data of the children with epilepsy included and finished the questionnaires, then completed the diagnosis of ADHD.Result1. The relationship between epilepsy-related clinical features and ADHD:There was no statistical difference (P>0.05) in the prevalence of ADHD between children with different sezure type. The earlier the epilepsy onset(less than one year old), the higher prevalence of ADHD occurring(P<0.05). The higher prevalence of ADHD in frequent seizure attack group(P<0.05).There was no statistical difference (P>0.05) in the prevalence of ADHD between children with different epilepsy duration, and aslo (P>0.05) in children with different discharge of EEG. The prevalence of ADHD in chilren with AEDs was higher than without AEDs, but there was no statistical difference (P>0.05). The prevalence of ADHD was higer in children with two or more AEDs than one AED (P<0.05).There was no statistical difference (P>0.05) in the prevalence of ADHD between each one AED group and chilren without AEDs, but the higher the prevalence of ADHD of two or more AEDs than chilren without AEDs(P<0.05). In the children with one type of AEDs, the prevalence of ADHD is higher in tradition AEDs group than new type AEDs (P<0.05).2. According to logistics regression analysis of the multiple factors influencing the the co-morbidity of ADHD, the status of seizure control was the significant factor in epilepsy children with AEDs, but there was no evidence of factors listed infacted the co-morbidity the ADHD in epilepsy children without ADEs.ConclusionThe factors associated with increased risk of ADHD included the onset age of epilepsy, frequent seizure attack, the effects of two and more AEDs and whether epilepsy is controlled or not.