Hyperkinetic Disorder/Attention Deficit Hyperactivity Disorder in Children with Epilepsy

Česká verzia

Authors: P. Cahová; J. Pejčochová; H. Ošlejšková
Authors place of work: Klinika dětské neurologie LF MU a FN Brno
Published in the journal: Cesk Slov Neurol N 2011; 74/107(2): 157-162
Category: Review Article

Summary

Hyperkinetic disorder, also known as attention deficit hyperactivity disorder (HKD/ADHD), is a neurodevelopmental disorder characterised by an age-related and inappropriate rate of hyperactivity with impulsivity together with an inability to remain focused on tasks or activities. HKP/ADHD incidence in children with epilepsy is estimated to be as high as 30%–40%. Several studies show that in children with ADHD the presence of epileptiform discharges can be found in 6%–51% of cases. The hypothesis that the comorbid incidence of epilepsy and ADHD may be merely coincidental is not accepted. Cognitive and behavioural changes in patients with epilepsy used to be explained as the consequences of recurrent seizures, the influence of antiepileptic medication and the substantial substrate of epilepsy. However, in the majority of ADHD and epilepsy children, the onset of ADHD symptomatology precedes the onset of clinical seizures. The onset of spontaneous seizures arises out of a complex process of epileptogenesis that involves a cascade of transcriptional changes involving the processes of plasticity, apoptosis and neurogenesis. All of these changes may influence the behavioural and cognitive profile before seizure onset. The pathophysiology of ADHD is explained by disturbances in the prefrontal-thalamo-striato-cortical neuronal circuits. It is the frontal lobe that is important to the understanding of the common neurobiological substrate of ADHD and epilepsy.

Key words:
hyperkinetic disorder – ADHD – epilepsy – frontal lobe epilepsy – childhood absence epilepsy – BECTS

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