Seizure occurrence in children diagnosed with ADHD
Seizure occurrence in children diagnosed with ADHD
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DOI：
10.1177/000992280104000408
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发表时间：
2001-04-01
影响因子：
1.6
通讯作者：
Griebel, ML
中科院分区：
文献类型：
--
作者：
Williams, J;Schulz, EG;Griebel, ML
B其他注意缺陷多动障碍（ADHD）和癫痫对儿童的学习、社会和行为发展有重要影响。ADHD儿童出现对立行为障碍、学习障碍、情感障碍和社会交往问题的风险增加，而癫痫儿童出现认知功能障碍、成绩不良和精神障碍的风险高于普通人群。2 ADHD，如果严格诊断，影响3%到5%的学龄儿童。3 ADHD可分为以注意力不集中为主要症状的儿童（主要为注意力不集中型）、以多动-冲动为主要症状的儿童（主要为多动-冲动型）和以混合症状为主要症状的儿童（混合型）。ADHD在男性中的风险从4：1增加到9：1，通常在上学早期被诊断出来。癫痫定义为一次以上的无诱因发作，影响1%的儿科人群，是儿童中最常见的神经系统疾病。[4]此外，热性惊厥发生在2%至5%的儿童中，尽管它们通常不需要治疗，并且通常在5岁时消退。5有热性惊厥的儿童以后发生无热性惊厥的风险增加1.5%至4.6%。6与癫痫高度相关的儿童期疾病包括智力迟钝（9-31%）、自闭症（11-35%）和脑瘫（18-35%）。7在智力迟钝和脑瘫的个体中，癫痫在41%至94%的患者中存在。8癫痫儿童被诊断为ADHD的风险也更高。Barkley 9指出20%-30%的癫痫患儿合并ADHD，Hempel等报道35%的难治性癫痫患儿被诊断为ADHD，但这两种疾病的表现和合并症的相对风险的时间关系尚不清楚。豪瑟等人使用DSM-IV标准确定冰岛新近诊断为无诱因癫痫发作的儿童与健康对照儿童相比的ADHD患病率。通过使用结构化电话访谈，他们发现注意力不集中型ADHD的患病率为37%，多动冲动型ADHD的患病率为29%。豪瑟等人认为，由于在癫痫发作诊断或抗惊厥药物治疗之前ADHD的发生率很高，因此ADHD是发展为癫痫的危险因素。设计了一项探索性研究，以检查诊断为ADHD的儿童癫痫发生率和风险之间的关系。
B oth attention deficit hyperactivity disorder (ADHD) and epilepsy have impor-tant implications for a child's learning, social, and behavioral development. Children with ADHD have an increased risk for oppositional behavioral disorders, learning disabilities, emo-tional disorders, and problems with social interaction,'while children with epilepsy have higher rates of cognitive dysfunction, underachievement, and psy-chiatric disturbance than in the general population. 2 ADHD, when strictly diagnosed, affects 3% to 5% of school-age children. 3 ADHD includes three subtypes: children with pri-mary symptoms of inattention (predominantly inattentive type)-,-children with primary symptoms of hyperactivity-impulsivity (predominantly hyperactive-impulsive type) and children with com-bined symptoms (combined type). ADHD, which has an in-creased risk from 4: 1 to 9: 1 in males, is generally diagnosed during the early school years. Epilepsy, defined as more than one unprovoked seizure, af-fects 1% of the pediatric population and is the most common neu-rologic disorder in children. 4 In addition, febrile seizures occur in 2% to 5% of children, although they do not typicallywarrant treat-ment and generally resolve by the age of 5 years. 5 Children with febrile seizures have a 1.5% to 4.6% increased risk of later developing afebrile seizures. 6 Child-hood disorders that are highly as-sociated with epilepsy include mental retardation (9-31% l), autism (11-35%), and cerebral palsy (18-35%). 7 In individuals with both mental retardation and cerebral palsy, epilepsy is present in 41% to 94% of the patients. 8 Children with epilepsy also have a higher risk of being diagnosed with ADHD. Barkley9 indicates that 20% to 30% of children with epilepsy have comorbid ADHD, and Hempel et al'0 reported that 35% of children with intractable epilepsy had been diagnosed with ADHD.However, the temporal relationship of presentation and rela-tive risk of comorbidity of these two disorders is unclear. Hauser et allI used criteria from the DSM-IV to determine the prevalence rate of ADHD in children in Iceland with newly diagnosed unpro-voked seizures compared to healthy controls. Through use of a structured telephone interview, they found a prevalence rate of 37% for ADHD, inattentive type, and a prevalence rate of 29% for ADHD, hyperactive-impulsive type. Hauser et all'contended that ADHD is a risk factor for developing epilepsy owing to its high rate of occurrence before seizure diagnosis or treatment with anticonvulsants. An exploratory study was de-signed to examine the relationship between occurrence and risk for epilepsy in children diagnosed with ADHD.