Salpekar Jay A, Mishra Gaurav
Center for Neuroscience and Behavioral Medicine, Children's National Medical Center, George Washington University School of Medicine, Washington, DC, USA.
Center for Neuroscience and Behavioral Medicine, Children's National Medical Center, George Washington University School of Medicine, Washington, DC, USA.
Epilepsy Behav. 2014 Aug;37:310-5. doi: 10.1016/j.yebeh.2014.04.021. Epub 2014 May 16.
Attention deficit hyperactivity disorder (ADHD) is a common comorbidity of epilepsy encountered by clinicians. However, relatively little information is available to guide optimal diagnostic and treatment strategies. Differentiating ADHD from effects of epilepsy requires careful history taking and emphasis upon characteristic symptoms and course of illness. Rating scales for ADHD are well validated and may aid clinical management. Use of antiepileptic drugs may cause cognitive or behavioral side effects yet may improve behavior in some cases. Historically, clinicians have been hesitant to treat ADHD comorbidity for fear of lowering the seizure threshold. However, an aggregate of recent evidence now suggests that stimulants may be well tolerated and effective for ADHD comorbid with epilepsy. Studies that further clarify pathophysiology and treatment outcomes are needed in order to enhance clinical efficacy and quality of life for this population.
注意缺陷多动障碍（ADHD）是临床医生在癫痫患者中常见的共病情况。然而，目前可用于指导最佳诊断和治疗策略的信息相对较少。将ADHD与癫痫的影响区分开来需要仔细询问病史，并着重关注特征性症状和病程。ADHD评定量表已得到充分验证，可能有助于临床管理。使用抗癫痫药物可能会引起认知或行为方面的副作用，但在某些情况下也可能改善行为。从历史上看，临床医生一直不愿治疗ADHD共病，因为担心会降低癫痫发作阈值。然而，近期的综合证据表明，兴奋剂对于合并癫痫的ADHD患者可能耐受性良好且有效。需要进一步阐明病理生理学和治疗结果的研究，以提高这一人群的临床疗效和生活质量。
