Epilepsy Talk

Is it ADHD…Epilepsy…or Both? | February 19, 2011


ADHD is the current term for the neurological condition formerly known as ADD (Attention Deficit Disorder), Hyperactivity, Hyperkinesis, Organic Brain Syndrome, Minimal Brain Dysfunction, and Minimal Brain Damage.

About 5 % of children in the general population have ADHD.  However, about 30-40% of children with epilepsy may have ADHD or attention problems. Also, ADHD is seen more often in boys than in girls (some medical professionals claim this ratio to be as high 4 to 1).

Interestingly, ADHD is often confused with epilepsy. Especially for kids who have staring spells, daydreamers or those who blank out frequently during the day. (“Johnny, you’re not paying attention!”). They could actually be absence seizures.

Either condition may be misdiagnosed as the inattentive type of ADHD and both can result in learning difficulties. Most of the time, it is an underlying brain problem that causes seizures, ADHD, and trouble learning. Less often, poorly controlled seizures and the adverse effect of antiepileptic drugs may impair attention and learning.

Michael Chez, M.D., Director of Pediatric Neurology at Sutter Neuroscience Institute, Sacramento, Calif., and Associate Professor of Neurology at the University of California, Davis, Calif., cautioned that all children who are inattentive at school don’t necessarily have absence epilepsy. He said, “If a child has lapses of attention both at school and at home, the diagnosis is often absence epilepsy. But if the staring spells just occur at school, it is probably attention deficit hyperactivity disorder.”

Two behaviors identified children with seizures versus children with ADHD with 96% accuracy: Their eyes became glassy, and the child did not fidget.

Dr. Knowles offered another clinical observation, “If a child is inattentive and doesn’t respond when you call him, it may be ADHD or a seizure. But if you touch the child and he still doesn’t respond, that is more suggestive of a seizure. Children with ADHD will respond when you touch them. It’s really easy to turn off your ears, but it’s much harder to tune out touch.”

Furthermore, seizures are episodic events and ADHD is a pervasive disorder that causes symptoms that are present throughout the day.

Children with suspected attention deficient difficulties may also be referred to a neuropsychologist for a more comprehensive assessment of their cognitive, academic, and behavioral functioning.

Neuropsychological tests usually include measures of overall intellectual functioning, academic achievement, and aspects of attention, language, spatial, motor, and memory abilities. Neuropsychologists also assess the overall presence and severity of psychological and behavioral difficulties. Based on this information, an informed assessment of ADHD symptoms can be made and a diagnosis provided.

In terms of medication, Ritalin has been shown to counteract the effectiveness of Phenobarbital.  Otherwise, newer antiepileptic medications generally have far fewer cognitive side effects and less negative drug interactions than did earlier generations of AEDs. And children can lead productive lives as long as they receive treatment early on.

Resources:

http://www.epilepsyfoundation.org/epilepsyusa/magazine/Issue4-2008/ADHD.cfm

http://www.epilepsyfoundation.org/about/related/ADHD/upload/AsktheExpert-ADHDandEpilepsy.pdf

http://my.epilepsy.com/node/987327

http://organizedwisdom.com/ADHD_and_Epilepsy_in_Kids

http://mayoresearch.mayo.edu/neurology/epilepsy.cfm

http://www.ehow.com/about_5548390_epilepsy-vs-add-children.html

http://www.wellsphere.com/add-adhd-article/medication-concerns-surrounding-adhd-and-epilepsy/578210

http://faces.med.nyu.edu/research/research-articles/attention-deficit-hyperactivity-disorder


10 Comments »

  1. Interesting concept to bring up! Working in the general field and then raising your own children. You really get a feeling of the importance of getting the ADHD vs sz ? answered. Having one child in speech delay, I noted friends of his that were diagnosed w/ ADHD. They were sweet but really could not verbally express themselves that way at home and at school. I always wondered if they were having petit mal seizures or simple partials. They stared a lot. One friend I did an EEG on and she did have 3 per second spike and slow wave and that was indicative of a petit mal seizure. It was during the hyperventilation portion of the EEG. Smart child but had staring spells at home and at school.

    It is interesting! One patient had them due to family history of alcoholism. Child was diagnosed w/ ADHD. The parent questioned it and had several EEG’s and during the hyperventilation the same thing happened w/ him. It took several tries.

    Research was done in family history of ETOH and the effectiveness to the child.

    Comment by Toni Robison — February 20, 2011 @ 9:15 AMFeb -04:00Feb

    • It’s really quite confusing and subversive. I liked the part where the doc said that you can call the person’s name and they may not react…whether it’s ADHD or absence seizures. But, if you TOUCH the person, that will be your first clue and can make all the difference…

      Comment by Phylis Feiner Johnson — February 20, 2011 @ 9:15 PMFeb -04:00Feb

  2. Hi.
    First my apology for not following your site to closely . I have gone through a spell of what I will call “not learning’ .Still reading but just not posting or trying to solve all my little details.
    I did read a lot of this info. as it came out and if I have any new questions about myself it has been with trying to understand partial szs. ,my “aura” and that always brings me to me as a juvenile.
    I will not argue the a.d.h.d. or a.d.d. facts or fiction . When I was just studying A.D.H.D. I lol a lot because I am the poster child or adult for this .
    I now understand myself well enough to say I have had an aura all my life ,although I have only had the t.c. type szs. for about 17 yrs.
    For my own curiosity I left to wonder if all the odd ball things I did as a kid,the learning problems I had,spatial thoughts,dreams,lack of attention,all of the things that they freely label as a.d.h.d. now ,were these signs of me having partial seizures?
    OR both? I “feel” I would have had to be a live in patient with a Neuro-psychologist when I was a teen in order for them to make any conclusions lol BUT I am still left wondering about the connections between the two.
    Another link I can see is my sister who had and still has migraines ,she also had serious learning problems as a kid . She was told all her life she was just paying attention and had the migraines.
    I was actually paying attention I was just three pages ahead of the rest of them or had all ready finished the book and refused to sit still. Thanks . Still very curious about any connection with these. Rick

    Comment by wichitarick — February 24, 2011 @ 9:15 PMFeb -04:00Feb

    • Welcome back.

      Here’s what I found: ADHD often accompanies epilepsy and learning disabilities.

      While seizures are bursts of uncontrolled electrical activity in the cortex of the brain, ADHD is a problem with attention.

      So I don’t think they’re mutually exclusive. And the relationship seems quite sensible. BUT, how many docs address it…

      RE: Your sister… Has she seen the article
      Epilepsy & Migraines — Kissing Cousins?

      http://epilepsytalk.com/2010/09/12/epilepsy-migraines-kissing-cousins/

      She might find it interesting!

      Comment by Phylis Feiner Johnson — February 24, 2011 @ 9:15 PMFeb -04:00Feb

  3. hi i have adhd and i have a helpar dog i passout in 2fignt at school for 1hr is it a FIT help me

    Comment by owen — April 13, 2011 @ 9:15 PMApr -04:00Apr

  4. it a fit i fick ?

    Comment by joy — April 13, 2011 @ 9:15 PMApr -04:00Apr

  5. i dont know what i have,other than a wild criminal history and more pills that do more harm than good. I am told i have onset adhd od add no real pipoint diognosis. I was never treated as a child. I grew up got into meth. I usedto goto peoples house give them as much as me and theyd damn near die. I am 38 years old and went clean for a few years,,my choice. Then woke up in the hospital frome almost crashing a semi truck.the told me i had a brain seizure,and that my life had just changed. I am on keppra xr anti convusant and meth based pills. But al of a suden my bp is high and i get chest and neck pain under stress. I am told it is a multiple seiz disorder triggered by onset hyperactive adhd. The seizes are some times the bite yourself and twitch but they say not quite grand mal. Can this be true?

    Comment by van — December 22, 2011 @ 9:15 AMDec -04:00Dec

  6. Illicit drug use, particularly cocaine, heroine, amphetamines, and PCP, can cause seizures. Alcohol withdrawal can be associated with seizure activity. These seizures usually occur 12-24 hours after the last drink but can occur up until 48 hours or more after binge drinking.

    Withdrawal from prescription drugs and agents such as barbiturates and narcotics can result in seizure activity.

    Head injury: Seizures may develop at or around the time of injury or years after (usually not more than two years later). They may occur with either an “open” or “closed” head injury.

    http://www.healthcommunities.com/epilepsy-seizures/seizure-causes.shtml

    My guess is the brain injury was cased by the drug use, which in turned, resulted in seizure(s).

    As for the ADHD diagnosis, I doubt it, I think it’s some doc being lazy. (Did I just say that? Naughty, naughty me.)

    The best way to find out where you stand is to see a neurologist. Do you have one already? If not, this list might help you: “Newly Updated Comprehensive List of GOOD Neurologists…Epileptologists…Neurosurgeons…and Pediatric Doctors”

    http://epilepsytalk.com/2011/05/03/newly-updated-comprehensive-list-of-good-neurologistsepileptologistsneurosurgeonsand-pediatric-doctors-2/

    As for your diagnostic options, here are a few, (although they’ll undoubtedly start with an EEG.)

    “Beyond EEGs…Diagnostic Tools for Epilepsy”

    http://epilepsytalk.com/2010/09/13/beyond-eegs%e2%80%a6diagnostic-tools-for-epilepsy-2/

    I hope this helps. Will you please get back to us and let us know how you do?

    Comment by Phylis Feiner Johnson — December 22, 2011 @ 9:15 PMDec -04:00Dec

  7. Ritalin Gone Wrong

    “THREE million children in this country take drugs for problems in focusing. Toward the end of last year, many of their parents were deeply alarmed because there was a shortage of drugs like Ritalin and Adderall that they considered absolutely essential to their children’s functioning.

    But are these drugs really helping children? Should we really keep expanding the number of prescriptions filled?

    In 30 years there has been a twentyfold increase in the consumption of drugs for attention-deficit disorder.

    As a psychologist who has been studying the development of troubled children for more than 40 years, I believe we should be asking why we rely so heavily on these drugs…”

    http://www.nytimes.com/2012/01/29/opinion/sunday/childrens-add-drugs-dont-work-long-term.html

    Comment by Phylis Feiner Johnson — January 31, 2012 @ 9:15 AMJan -04:00Jan


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    Important Resources

    • The Epilepsy Foundation of Eastern Pennsylvania. The EFEPA provides many important services, including a wonderful camp for kids with epilepsy…epilepsy seminars for first aid…awareness and education…and advocacy support.
    • The Epilepsy Foundation. Dedicated to improving how people with epilepsy are perceived, accepted and valued in society; and promoting research for a cure.

    About the author

    Phylis Feiner Johnson has been a professional copywriter for 30 years. She also spent 20 years with epilepsy. She writes from the heart to increase education, awareness and funding for epilepsy research. For further information, contact The Epilepsy Foundation of Eastern Pennsylvania at http://www.efepa.org/ and please make a contribution to become an advocate, too.

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