Attention Problems in Children with Epilepsy. How is the Long-Term Outcome?

Aims: Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders and frequently seen in epilepsy as well. The prevalence of ADHD in epilepsy is significantly higher than in the general pediatric population. How these attention problems develop over the years is however not clear. We therefore, evaluated the severity of attention problems in epileptic children at late childhood and assessed it again in adolescence. Data were being compared with attention problems of children with developmental ADHD.

Methods: A total of 16 boys with diagnosed combined idiopathic epilepsy/ADHD and 14 boys with developmental ADHD were investigated at a mean age of 10.94 (SD = 1.63) years, and then again at a mean age of 15.82 (SD = 2.0) years. All the patients completed Raven Progressive Matrices to assess intelligence. To measure symptom severity of ADHD, parents completed the short version of the Conner Rating Scale for Parents at both the times.

Results: Patient groups did not significantly differ in age and IQ. Results of the baseline examination revealed elevated scores in both patient groups for the Conner Rating Scales; ADHD group: M = 16.86 (SD = 5.35); epilepsy/ADHD group: M = 14.77 (SD = 4.76) but no differences between the groups (p = 0.29; z = 0.39). The results of the follow-up examination showed a significant reduction of symptoms in the ADHD group of −4.23 points; M = 12.63 (SD = 3.89) (p = 0.02). The reduction in the epilepsy/ADHD group was even bigger with −6.77 points; M = 8.00 (SD = 6.46) (p = 0.03). However, difference between the two groups reached no significance (p = 0.079; z = 1.19).

Conclusion: We found a significant reduction of ADHD symptoms in our patients from the time of late childhood to adolescence. The symptoms of ADHD lessen with age, and are known from the literature. We found the same data for patients with idiopathic epilepsy and ADHD. Over the same period of time, problems of attention improved substantially. We conclude that development and brain maturation may have a similar positive effect on attention problems in children with epilepsy than in developmental ADHD.

Keywords: epilepsy, ADHD.