Abstracts

ADHD is a frequent comorbid condition in pediatric epilepsy, especially in tertiary care centers. In a large sample of children with epilepsy, we aimed to determine (1) the prevalence of ADHD symptoms, (2) neurological and epilepsy-related risk factors for ADHD, 3) the influence of intellectual deficits on the expression of ADHD in epilepsy, and 4) the extent to which ADHD symptoms pose a risk for poor health-related quality of life (HRQOL) and restrictions in daily activities in children with epilepsy. We also explored whether there was an epilepsy-specific presentation of ADHD in children with epilepsy., Data from the ADHD Rating Scale-IV (ADHD-IV) from 203 cases (mean age = 11.8, SD = 3.8) from a tertiary centre serving children with severe epilepsy were reviewed. The majority of children had focal symptomatic epilepsy, with a median seizure frequency of 3 seizures per month and median age at onset of 2.5 years., Clinically significant problems with Inattention were more frequent than problems with Hyperactivity-Impulsivity (40% of children vs. 18%). About 2/3 of the sample met screening criteria for either ADHD-I or ADHD-C, with equal representation of both subtypes. Age of onset, epilepsy duration, and intractability did not predict ADHD symptoms or subtype, but ADHD-I was more prevalent in localization-related epilepsies, and there was a trend for higher medication load in this subgroup. Severity of ADHD symptoms was inversely related to HRQOL. Overall, ADHD-C children were younger, had low functional levels, had the poorest HRQOL and the most restrictions in daily activities. No gender difference in the prevalence of ADHD subtypes was seen., Children seen at tertiary care centres for severe epilepsy are at high risk for attention problems and ADHD. The clinical characteristics of ADHD occurring in the context of epilepsy differ significantly from the known characteristics of children with primary ADHD, raising questions about the validity of using the DSM-IV-based criteria and the notion of comorbidity to describe what may be an epilepsy-specific disturbance in children with severe epilepsy., (Supported by BC Medical Services Foundation/Vancouver Foundation.)