Epilepsy in children with attention-deficit/hyperactivity disorder.
Epilepsy in children with attention-deficit/hyperactivity disorder.
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DOI：
10.1016/j.pediatrneurol.2010.01.005
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发表时间：
2010-05
影响因子：
3.8
通讯作者：
Wirrell EC
中科院分区：
文献类型：
--
作者：
Davis SM;Katusic SK;Barbaresi WJ;Killian J;Weaver AL;Ottman R;Wirrell EC
先前的研究表明，癫痫儿童中注意力缺陷/多动障碍的症状发生率较高，但很少有人研究注意力缺陷/多动障碍儿童的癫痫。我们的目的是比较癫痫的发病率和特点之间的人口为基础的，研究确定队列的儿童（N=358）和无注意缺陷/多动障碍（N=728），根据医疗记录审查到20岁。提取的数据包括癫痫发作、检测和治疗的特征。病例发生癫痫的可能性是对照组的2.7倍（95%置信区间0.94-7.76; p=0.066），癫痫发作较早（中位年龄5.5岁vs 15岁; p=0.020），癫痫发作频率有增加的趋势（超过每月一次，63% vs 17%）。在注意力缺陷/多动障碍儿童中，癫痫患者接受注意力缺陷/多动障碍临床诊断（63% vs 89%; p=0.052）或接受兴奋剂治疗（50% vs 85%; p=0.025）的可能性较小。我们的研究结果表明，与没有注意力缺陷/多动障碍的儿童相比，注意力缺陷/多动障碍儿童癫痫的发病率有明显的上升趋势。注意力缺陷/多动障碍儿童的癫痫似乎比没有注意力缺陷/多动障碍的儿童更严重。最后，似乎不愿意诊断和开始治疗癫痫儿童的注意力缺陷/多动障碍。
Prior studies suggest a higher incidence of symptoms of attention-deficit/hyperactivity disorder in children with epilepsy, but few have investigated epilepsy in children with attention-deficit/hyperactivity disorder. Our objective was to compare the incidence and characteristics of epilepsy among population-based, research identified cohorts of children with (N=358) and without attention-deficit/hyperactivity disorder (N=728), based on medical record review to age 20. Data abstracted included characteristics of seizures, testing, and treatment. Cases were 2.7 times more likely to have epilepsy than controls (95% confidence interval 0.94–7.76; p=0.066), had earlier seizure onset (median age 5.5 versus 15 years; p=0.020), and a trend toward more frequent seizures (more than monthly, 63% versus 17%). Among children with attention-deficit/hyperactivity disorder, those with epilepsy tended to be less likely to have received a clinical diagnosis of attention-deficit/hyperactivity disorder (63% versus 89%; p=0.052) or to be treated with stimulants (50% verses 85%; p=0.025). Our findings suggest a strong trend towards a higher incidence of epilepsy among children with attention-deficit/hyperactivity disorder compared to those without. Epilepsy in children with attention-deficit/hyperactivity disorder appears to be more severe than in those without. Finally, there appears to be a reluctance to diagnose and initiate treatment for attention-deficit/hyperactivity disorder in children with epilepsy.
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