1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-25-26 10.15844/pedneurbriefs-25-4-2 Seizures and Related Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant ADHD in Children with Benign Epilepsy and Siblings http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 04 2011 01 01 2016 25 4 26 27 Copyright: © 2011 The Author(s) 2011 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Attention-deficit hyperactivity disorder in children with benign epilepsy and their siblings

The prevalence and characteristics of ADHD in children with benign epilepsy and in their nonepileptic siblings were compared in a prospective study at Carmel Medical Center, Haifa, Israel.

 Benign Epilepsy Nonepileptic Siblings Frontal/Prefrontal Lobe Growth Retardation

The prevalence and characteristics of ADHD in children with benign epilepsy and in their nonepileptic siblings were compared in a prospective study at Carmel Medical Center, Haifa, Israel. Of 40 patients with benign epilepsy, 21 (52.5%) had generalized seizures, 16 (40%) had partial seizures, 8 (20%) had absence epilepsy, and 5 (12.5%) benign epilepsy with centrotemporal spikes. Of 28 (70%) diagnosed with ADHD, 19 had the inattentive type, 1 with hyperactive type, and 8 with the combined type. Of 12 nonepileptic siblings in the control group, only 2 (16.7%) had ADHD (P<0.03). Children with seizures more resistant and requiring more than 1 AED showed a trend toward an increased risk of attention disorder. Children with more epileptiform discharges in their EEGs were more likely to have ADHD. Of patients with normal EEGs, 50% had ADHD whereas of children with >6 interictal spikes or S/W complexes per minute, 92% had ADHD. Learning disabilities were more common in the epilepsy group (42.5% vs 25% in the control group, P<0.05). [1]

COMMENT. The prevalence of ADHD in school-age children with epilepsy is between 20% (Gross-Tsur et al. 1997) and 60% (Sherman et al. 2007). The prevalence of epileptiform EEGs in nonepileptic children evaluated for ADHD is 26%, compared to 3.5-6.5% in healthy children (Kaufmann et al. 2009; Millichap et al. 2010). The present report shows an increased risk of attention disorder in children with AED-resistant seizures and having more frequent epileptiform discharges in the EEG. ADHD is particularly common in benign epilepsy of childhood with centrotemporal spikes and frontal lobe epilepsy. The comorbidity of ADHD and epilepsy may depend on the effects of AEDs, psychosocial aspects of epilepsy, the type and localization of epileptogenic foci, or even common genetic factors.(Kaufmann R et al. 2009).

Frontal/prefrontal lobe growth retardation is reported in children with BCECTS complicated by cognitive impairments and behavioral problems compared with BCECTS patients without neuropsychiatric deficits [2]. Impaired frontal lobe growth is associated with frequent seizures and spike/wave discharges and neuropsychological problems. A small percentage of BCECTS patients may require early control of seizures to prevent frontal lobe growth retardation and associated cognitive and behavioral problems.

Bennett-Back O Keren A Zelnik N Attention-deficit hyperactivity disorder in children with benign epilepsy and their siblings Pediatr Neurol 2011 Mar 44 3 187 192 10.1016/j.pediatrneurol.2010.10.003 21310334 Kanemura H Hata S Aoyagi K Sugita K Aihara M Serial changes of prefrontal lobe growth in the patients with benign childhood epilepsy with centrotemporal spikes presenting with cognitive impairments/behavioral problems Brain Dev 2011 Feb 33 2 106 113 10.1016/j.braindev.2010.03.005 20381984