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.

To subscribe to Epilepsytalk.com and get the latest articles by email, simply go to the bottom box of the right column and click on “Sign Me Up!”

 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


14 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.

    Like

    Comment by Toni Robison — February 20, 2011 @ 2:57 AM

    • 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…

      Like

      Comment by Phylis Feiner Johnson — February 20, 2011 @ 7:24 PM

  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

    Like

    Comment by wichitarick — February 24, 2011 @ 8:29 PM

    • 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?

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

      She might find it interesting!

      Like

      Comment by Phylis Feiner Johnson — February 24, 2011 @ 11:51 PM

  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

    Like

    Comment by owen — April 13, 2011 @ 10:11 PM

  4. it a fit i fick ?

    Like

    Comment by joy — April 13, 2011 @ 10:17 PM

  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?

    Like

    Comment by van — December 22, 2011 @ 2:31 AM

  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”

    https://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”

    https://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?

    Like

    Comment by Phylis Feiner Johnson — December 22, 2011 @ 3:52 PM

  7. Could A Club Drug Offer ‘Almost Immediate’ Relief From Depression?

    http://www.npr.org/blogs/health/2012/01/30/145992588/could-a-club-drug-offer-almost-immediate-relief-from-depression?ft=1&f=100

    Like

    Comment by Phylis Feiner Johnson — January 31, 2012 @ 12:14 AM

  8. 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

    Like

    Comment by Phylis Feiner Johnson — January 31, 2012 @ 12:17 AM

  9. I have recently started taking medication for ADD just in the last 4 months. I’m 38 and it’s time to get some focus in my life. I have Epilepsy and have been aware & treated since I was 18. When I was in grade school I had struggles & would often be accused of day dreaming or purposely not paying attention even though I would have no recollection it was happening when I was questioned by teachers & parents. I was put on CYLERT for Dyslexia from 4-6th grade. I was & am very unorganized, sloppy, emotional, random & overthink everything & have severe anxiety. When I was 18 I had a Grand Mal seizure while pregnant, Dr. thought it was attributed to pregnancy. Well I’ve had about 300 plus Tonic Clonic seizures in the last 20 yrs & have learned from Dr.s & loads of test that I have always had Generalized Epilepsy. I know a lot about Epilepsy & have been handling getting that part of my life & have it somewhat under control, I am so excited to tackle the ADD side. This was such a great read!

    Like

    Comment by Katie — January 19, 2013 @ 4:02 AM

  10. Good for you Katie, for being so pro-active! That’s the most important thing… It’s the BEST thing you can do for yourself. (Versus denial, which many if us are guilty of.)

    Like

    Comment by Phylis Feiner Johnson — January 19, 2013 @ 9:50 AM

  11. Im Worried about my son he is 11 and ADHD was diagnosed when he was 8 the thing is he totally spaced out on the school bus first time he has done this and ended up at least ten miles away from home fortunatly he stayed on the bus which went back the same way and arrived late but safely to school could this have been some type of seizure as we are now wondering if this is some form of epilepsy please could someone help?

    Like

    Comment by Claire — January 27, 2014 @ 6:46 AM

  12. I’m really not sure. But I am sure that he should at least see a neurologist. He could have simply been disoriented, or he could have had any of a number of different types of seizures. (I’m no doc!)

    This link may help. It’s a compilation by website forum members who have had personal positive experiences with docs over the years.

    PEDIATRIC RECOMMENDATIONS

    ARIZONA

    Dr. Kevin Chapman, Barrows Neurological Institute, Phoenix, AZ — Pediatric Epileptologist / Neurologist
    Dr. Randa Jarrar, Phoenix Children’s Hospital, Phoenix, AZ

    CALIFORNIA
    Dr. Kelfer, Cook’s County Children’s Medical Hospital, Los Angles, CA
    Dr. Nutik, Kaiser, Redwood City, CA
    Dr. Donald Shields, UCLA Mattel Children’s Hospital Division of Pediatric Neurology, CA
    Dr. Diane Stein, Irvine, CA
    Dr. Joyce Wu, UCLA Mattel Children’s Hospital Division of Pediatric Neurology, CA
    Dr. Mary Zupanc, Children’s Hospital, Orange County, CA — Epileptologist

    CHICAGO

    Dr. Douglas Nordli, Children’s Memorial Hospital, Chicago, IL — Pediatric Epileptologist

    CONNETICUT

    Dr. Francine Testa, Yale-New Haven Hospital, New Haven, CT
    Susan Levy, Yale-New Haven Hospital, New Haven, CT
    Dr. Laura Ment, Yale-New Haven Hospital, New Haven, CT

    FLORIDA

    Dr. Ronald Davis, Orlando, FL
    Dr. Kojik, Orlando, FL
    Dr. Naqvi, Miami Children’s Hospital, Miami, FL
    Dr. Passero, St. Petersberg, FL

    GEORGIA

    Dr. Robert Flamini, Scottish Rite Children’s Hospital, Atlanta, GA
    Dr. Sandra Helmers, Emory University, Atlanta, GA
    Dr. Roger Hudgins, Scottish Rite Children’s Hospital, GA

    ILLINOIS

    Dr. Marianne Larsen, Children’s Memorial Hospital, Chicago, IL
    Dr. Marvin A. Rossi, Rush University Medical Center, Chicago, IL
    Dr. Blas Zelaya, Peoria, IL

    INDIANA

    Dr. Vicenta Salanova, Riley Hospital for Children, Indianapolis, IN

    KENTUCKY

    Dr. Vinary Puri, Director of Child Neurology, Kosair Children’s Hospital and University of Louisville, Louisville, KY

    MARYLAND

    Dr. Eric Kossof, Johns Hopkins, Baltimore, MD
    Dr. William R Leahy, Greenbelt, MD
    Dr. Naidu, Kennedy Krieger Institute, Baltimore, MD

    MASSACHUSETTS

    Dr. Adjani, UMassachusetts Medical Center, MA
    Dr. Blaise Bourgeois, Children’s Hospital, Boston, MA
    Dr. Laurie Douglass, Boston, MA
    Dr. Frances E. Jensen, Children’s Hospital, Boston, MA
    Dr. Joseph Madsen, Children’s Hospital, Boston, MA
    Dr. Annapurna (Ann) Poduri, at Boston Children’s Hospital, Boston, MA
    Dr. Kenneth Sassower, Massachusetts General Hospital, Boston, MA — Children & Adults — Neurologist/Epileptologist
    Dr. Ronald Thibert, Massachusetts General Hospital, Boston, MA
    Dr. Elizabeth Thiele, Massachusetts General Hospital, Boston, MA — Pediatric Neurologist and Epileptologist

    MICHIGAN

    Dr. Harry Chugani, Detroit Children’s Hospital, Detroit, MI
    Dr. Eileen McCormick, Michigan Institute for Neurological Disorders (MIND), Farmington Hills, MI

    MINNESOTA

    Dr. Jason Doescher, Minnesota Epilepsy Group, St. Paul, MN
    Dr. Mary Dunn, St. Paul Children’s, St. Paul, MN
    Dr. Frost, Minnesota Epilepsy Center, St. Paul, MN

    MISSOURI

    Dr. David Callahan, St. Luke’s Hospital, West Chesterfield, MO
    Dr. James Rohrbaugh, St Luke’s Hospital, Chesterfield, MO
    Dr. William Rosenfeld, Children’s Hospital, St. Louis, MO
    Dr. Micheal Symth, St. Louis Children’s Hospital, St. Louis, MO — Neurosurgeon
    Dr. Richard Torkelson, Children’s Mercy, Kansas City, MO
    Dr. Edwin Trevathan, St. Louis Children’s Hospital, St. Louis, MO
    Dr. John Zempel, St. Louis Children’s Hosptial, St. Louis, MO — Epileptologist

    NEW JERSEY

    Dr. Daniel Alder, New Jersey
    Dr. Steven Kugler, Robert Wood Johnson Hospital, New Brunswick, NJ
    Dr. Wollack, Robert Wood Johnson Hospital, New Brunswick, NJ

    NEW YORK

    Dr. Claudia Chiriboga, Columbia Presbyterian, New York City, NY
    William S. MacAllister, Ph.D., Pediatric Neuropsychologist, NYU Comprehensive Epilepsy Center, New York City, NY
    Dr. Gail Solomon, NYU Comprehensive Epilepsy Center, New York City, NY

    NORTH CAROLINA

    Dr. Corbier, Concord, NC
    Dr. Darrell V. Lewis, Duke Children’s, Atlanta, NC
    Dr. Gallentine, Duke Children’s, Atlanta, NC
    Dr. Michael B. Tennison, Chapel Hill, NC
    Dr. Shana Wallace, Charlotte, NC

    OHIO

    Dr. Kerry Crone, Children’s Hospital Medical Center, Cincinnati, OH
    Dr. Cynthia Foldvary, Cleveland Clinic, Cleveland, OH
    Dr. David Franz, Children’s Hospital Medical Center, Cincinnati & Mason, OH
    Dr. Gupta, Cleveland Clinic, Cleveland, OH
    Dr. Roger Hudgins, Akron Children’s Hospital, Akron, OH
    Dr. Kotogal, Cleveland Clinic, Cleveland, OH – Epileptologist
    Dr. Lichwanni, Cleveland Clinic, Cleveland, OH — Epileptologist
    Dr. Ingrid Tuxhorn, Rainbow’s Babies and Children’s Hospital, Cleveland, OH
    Dr. Wyllie, Cleveland Clinic, Cleveland, OH — Epileptologist

    PENNSYLVANIA

    Dr. Khurana, St. Christopher’s Hospital, Philadelphia, PA
    Dr. Roger Porter, Children’s Hospital of Philadelphia, Philadelphia, PA
    Dr. Strom, Children’s Hospital of Philadelphia, Philadelphia, PA

    TENNESSEE

    Dr. Stephen Fulton, LeBonheur Children’s Hospital, Memphis, TN — Epileptologist
    Dr. Paul Knowles, T.C. Thompson’s Children’s Hospital, Chattanooga, TN
    Dr. Barbara Olsen, Pediatric Neurology Associates, Nashville, TN
    Dr. James Wheless, LeBonheur Children’s Hospital, Memphis, TN

    TEXAS

    Dr Gretchen Von Allmen, UT Physicians/Memorial Hermann Hospital, Houston, TX
    Dr. Imad T. Jarjour, Houston, TX
    Dr. Howard Kelfer, Cook Children’s Medical Center, Fort Worth, TX
    Dr. Anthony Riela, Texas Child Neurology, Plano, TX
    Dr. Josh Rotenberg, Pediatric Neurologist, Texas Medical & Sleep Specialists, San Antonio and Houston, TX
    Dr. Angus Wilfong, Texas Children’s Hospital, Houston, TX

    VIRGINIA

    Dr. Pearl, Fairfax, Virginia

    WASHINGTON

    Dr. Jeff Ojemann, University of Washington, Seattle, WA

    WASHINGTON, D.C.

    Dr. Pearl, Children’s National Medical Center, Washington, D.C.

    WISCONSIN

    Dr. Kurt Hecox, Children’s Hospital of Wisconsin, Milwaukee, WI
    Dr. S. Anne Joseph, Children’s Hospital of Wisconsin, Milwaukee, WI
    Dr. Lew, Children’s Hospital of Wisconsin, Milwaukee, WI
    Dr. Marcuccilli, Milwaukee, WI – Epileptologist

    https://epilepsytalk.com/2014/01/05/2014-comprehensive-list-of-good-neurologistsepileptologistsneurosurgeonsand-pediatric-doctors/

    Good luck!

    Like

    Comment by Phylis Feiner Johnson — January 27, 2014 @ 11:13 AM


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    About the author

    Phylis Feiner Johnson

    Phylis Feiner Johnson

    I've been a professional copywriter for over 35 years. I also had epilepsy for decades. My mission is advocacy; to increase education, awareness and funding for epilepsy research. Together, we can make a huge difference. If not changing the world, at least helping each other, with wisdom, compassion and sharing.

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