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DOI: 10.1055/s-0038-1628750
ADHS bei Kindern und Jugendlichen mit Epilepsie
ADHD in children and adolescents with epilepsyPublication History
Eingegangen am:
22 January 2010
angenommen am:
29 January 2010
Publication Date:
25 January 2018 (online)
Zusammenfassung
ADHS (Aufmerksamkeits-/Hyperaktivitätssyndrom) hat erhebliche Auswirkungen auf die schulische und soziale Prognose der betroffenen Kinder bis ins Erwachsenenalter. ADHS findet sich bei 20 bis 30% der Kinder und Jugendlichen mit Epilepsie. Dies betrifft nicht nur Kinder mit symptomatischen Epilepsien oder neurologischen Defiziten, sondern im gleichen Maße Kinder mit idiopathischen Epilepsien. Häufiger als bei Kindern ohne Anfälle findet sich eine isolierte Aufmerksamkeitsstörung. Neuere Untersuchungen zeigen, dass die ADHS-Symptomatik den Anfällen in vielen Fällen vorausgeht. Dies könnte dafür sprechen, dass nicht die Anfälle oder deren Therapie Ursache der Aufmerksamkeitsstörung sind, sondern dass eine gemeinsame Ursache für beide Erkrankungen vorliegt. Symptome eines ADHS müssen in der kinderepileptologischen Sprechstunde regelmäßig und gezielt erfragt werden. Bei Schulleistungsstörungen oder Verhaltensauffälligkeiten ist eine umfassende Diagnostik notwendig. Die Behandlung eines ADHS erfolgt bei Kindern mit Epilepsie nach denselben Standards wie bei ansonsten gesunden Kindern und umfasst die Gabe von Psychostimulantien, verhaltenstherapeutische Maßnahmen und Psychoedukation. Methylphenhydat ist bei Kindern mit ADHS und Epilepsie sicher und ebenso wirksam wie bei Kindern ohne Epilepsie.
Summary
Attention deficit hyperactivity disorder (ADHD) has serious prognostic implications concerning academic and social achievement. ADHD is more frequent in children with epilepsy than in the general population. This has been shown not only for children with neurological deficits or symptomatic epilepsy but also for children with idiopathic epilepsies. ADHD in children with epilepsy is predominantly characterized by the inattentive variant and may antedate the onset of seizures in the majority of children. This finding may indicate that both ADHD and epilepsy may be related to the same neurodevelopmental abnormality. Physicians treating children with epilepsy should regularly ask for symptoms indicative of ADHD. In case of behavioural or learning problems a thorough diagnostic has to be undertaken. Treatment of ADHD in children with epilepsy is essentially the same as in otherwise healthy children. Methylphenidate is considered safe and effective for children with well-controlled epilepsy.
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