Abstracts

The comorbidity of Attention Deficit Hyperactivity Disorder (ADHD) in pediatric epilepsy patients has been reported to range from 20-50%. We sought to evaluate chronic epilepsy patients with the use of two well-established, standardized questionnaires in order to characterize possible ADHD symptoms. Chronic epilepsy patients were recruited from a major metropolitan tertiary care pediatric epilepsy program. Patients with IQ suspected to be below 70 were not included. A parent completed the Child Behavior Checklist (CBCL) and the Conner[apos]s Parent Rating Scale (Revised-S). The CBCL is a 113-item scale that measures many aspects of behavior, and generates standardized scores for broad-band (Total, Externalizing and Internalizing) and narrow-band (Withdrawn, Somatic, Anxiety/Depression, Social, Thought, Attention, Delinquency, Aggression) behavior categories. The Conner[apos]s Scale is a 27-item measure geared toward ADHD symptoms, that generates standardized scores in subcategories of oppositionality, hyperactivity, and inattention, as well as a general ADHD index score. Data was obtained prospectively following consenting of subjects (parents). The cutoff point for clinical significance was a t-score of 65. 25 pediatric epilepsy patients were assessed via parent reports. The average age was 11.3 (range 6-17), with 13 males and 12 females. 19 patients had complex partial seizure disorder and 6 had primary generalized seizure disorder. Ten (40%)subjects scored in the range of clinical significance on the inattention subcategory of the CBCL. 12 subjects (48%) scored high on the inattention subcategory of the Conner[apos]s Scale. All except one of those subjects also scored high on the ADHD Index Scale. Nine subjects scored high on oppositionality, and eight scored high on the hyperactivity category of the Conner[apos]s Scale. Eight (32%) subjects had attention problems measurable in the clinical range by both the CBCL and the Conner[apos]s Scale. 3/6 (50%) patients with primary generalized seizure disorder, and 11/19 (58%) patients with complex partial seizure disorder, scored high on at least one of the attention problem scales. Attention problems were common in this group of pediatric epilepsy patients, at a level consistent with existing studies. ADHD symptoms were present in both partial and generalized seizure disorder patients. Inconsistencies were present in some cases where one measure indicated attention problems that were not captured by the other instrument. Further study with a larger sample and correlation with semi-structured psychiatric interviews may help to clarify the utility of each of these important ADHD screening tools. ADHD screening should play a prominent role in the care of pediatric epilepsy patients. (Supported by Children[apos]s Research Institute, Children[apos]s National Medical Center, Washington, DC 20010.)