Isolated corpus callosum agenesis as a rare differenzial diagnosis of attention defficit hyperactivity disorder- case report

Introduction: Impaired concentration and attention are frequent problems in school children. The Attention-deficit/hyperactivity disorder (ADHD) signs and symptomes could be mistaken for a many other conditions. The knowledge of typical seizure manifestation in children with active Absence Epilepsy leads fast to the epilepsy suspicion, once the therapy with stimulants fails.

Methods: Here we present a case of a rare differenzial diagnosis of ADHD.

Outcome: A nine years old, normal developed girl with known, therapy refractory ADHD- inattative typ presented in our centre for assessment of absence epilepsy. The frequent episodes of behavioural arrest and unresponsiveness that lasted for a few seconds („starring spells„) were observed many times a day. After the therapy with stimulant methylphenidat (MPH) no improvement showed, absence epilepsy was suspected. During the assessment in our centre we registered EEGs without any epileptiform discharges, so that an active epilepsy could be ruled out. However, the sleep- EEG records (decreased interhemispheric EEG coherence during sleep) suggested the brain malformation- agenesis of corpus callosum, which was confirmed on the reevaluation brain MRI.

Conclusion: This case illustrates the importance of exerting every effort possible to rule out any serious medical conditions, before inappropriate administration of medications, particularly since the incidence of isolated agenesis of corpus callosum in normal intelligent children with pronounced concentration impairment is unknown.