Epilepsy Talk
Is it ADHD…Epilepsy…or Both? | June 30, 2020
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 anti-epileptic 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 anti-epileptic 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.
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Resources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4755462/
https://practicalneurology.com/articles/2015-mar/your-attention-please-adhd-linked-with-epilepsy
https://www.neurologytimes.com/epilepsy-and-seizure/adhd-symptoms-common-adult-epilepsy
Tags: absence seizures, academic achievement, ADHD, attention problems, behavioral difficulties, cognitive, hyperactive disorder, inattentiveness, intellectual, language, learning difficulties, memory, motor, neuropsychologist, Ritalin, spatial, staring spells
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Pingback by Is it ADHD…Epilepsy…or Both? — Epilepsy Talk – Epilepsy & Cerebral Palsy — June 30, 2020 @ 10:39 AM
What do they call it when you take MORE MGS OF AED’s as a child, & see & watch your school grades go down, and you try extra hard to remember more than what you are able to remember, BECAUSE OF the increases of MGS from AED’s ? That happened to me just as I explained it around 1970-1978, when before 5th grade I was getting A’s & B’s for school grades. Wasn’t until 2006 that a neurologist tells me that the drug Meberal ”’that is not made today”’, made kids partially mentally retarded. Strange how I learned that at age 46 & not at age 6 or before age 18. The logo for medical profession / practice is not a snake by mistake.
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Comment by James D — June 30, 2020 @ 7:59 PM
“A snake by mistake.” How well said. Too bad that the truth always seems to arrive after the fact. 😦
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Comment by Phylis Feiner Johnson — June 30, 2020 @ 9:13 PM
And what were your grades like after you found out you were an epileptic? James D. Because it appears your intelligence really wasn’t affected after all. You just had to work a little bit harder. Makes me wonder if “Albert Einstein” was referred to as “RETARDED”?
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Comment by Kathy S.B — July 3, 2020 @ 12:45 PM
I was told that my six yr old son had ADD even though he had lapses of attention at random times and excellent grades in school. Now I know that they were absence seizures and have unfortunately devolved into more seizure activity now that he’s an adult –
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Comment by Mpbaker — July 1, 2020 @ 8:53 PM
The unfortunate thing is that the two are often confused, especially in childhood. This misdiagnosis leads to unnecessary or the wrong meds, which lead to side effects of their own. I’m so sorry to hear about your son. But, hopefully, now that he’s properly diagnosed, he is on appropriate medication that helps his seizures.
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Comment by Phylis Feiner Johnson — July 1, 2020 @ 9:31 PM
Up until my little town finally had a new doctor (when I was little) the OLD DOCTOR told my grandma and great grandparents that I had ADHD and was HYPERACTIVE!!!!! Until I got a new younger doctor (in town) who knew I was having “GRANDMAL SEIZURES” based on his own personal experiences and family member. I STILL TALK TO HIM NOW!!!!!!! HE IS AN ANGEL I SWEAR AND I WISH HE NEVER EVER RETIRED!!!!!!!
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Comment by Kathy S.B — July 3, 2020 @ 12:40 PM
My doctor had me on Ritalin, if you can believe it.
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Comment by Phylis Feiner Johnson — July 3, 2020 @ 12:43 PM