Department of Neurology, Charles Nicolle Hospital, Tunis, Tunisia.
Department of Neurology, Charles Nicolle Hospital, Tunis, Tunisia.
Epilepsy Behav. 2021 Jan;114(Pt A):107583. doi: 10.1016/j.yebeh.2020.107583. Epub 2020 Nov 24.
The aim of our study was to analyze electrophysiological findings in patient with Attention Deficit Hyperactivity Disorder (ADHD) by electroencephalography (EEG) recording, estimate the prevalence of epilepsy in ADHD population and assess its clinical characteristics.
We conducted a retrospective and analytic study that concerned children with ADHD, followed for at least two-years in the Tunisian National Center for School and University Medicine (NCSUM). All patients recruited underwent at the diagnosis of ADHD, neurological examination and EEG recording in the department of Neurology of Charles Nicolle Hospital. Medical data including family history, ictal semiology and ADHD features were assessed.
Thirty patients were enrolled in our study. Mean age was 12.27 years with a sex ratio of 3.28. Mean age at diagnosis of ADHD was 6.6 years. Attention Deficit Hyperactivity Disordercombined subtype was seen in 18/30 patients, Hyperactive/ Impulsive subtype in 7/30 patients and Inattentive subtype in 5/30 patients. Epilepsy-disease was reported in 20% (Seizures preceded the diagnosis of ADHD in 3/6 cases and appeared after an average of 3.67 years in 3/6 cases). Mean age of seizure onset was 7 years. Seizure-types were generalized (motor 4/6 cases, absence-type (1/6 case)) and focal (1/6 case). Electroencephalography revealed Epileptiform discharges in 30% with frontal and left dominance. Interictal discharges were significantly associated with younger age of onset (p: 0.02), inattentive subtype (p: 0.04) and intellectual disability (p: 0.04). These discharges was not associated with epilepsy.
Our results have shown that epileptiform discharges could be used as risk factor for seizures and cognitive impairment which may influence outcome in ADHD population.
我们的研究旨在通过脑电图（EEG）记录分析注意力缺陷多动障碍（ADHD）患者的电生理发现，评估 ADHD 人群中癫痫的患病率，并评估其临床特征。
我们进行了一项回顾性分析研究，涉及在突尼斯国家学校和大学医学中心（NCSUM）至少随访两年的 ADHD 儿童。所有入组的患者在 Charles Nicolle 医院神经病学系接受 ADHD 诊断时，均接受了神经系统检查和脑电图记录。评估了包括家族史、发作半侧性和 ADHD 特征在内的医疗数据。
我们的研究纳入了 30 名患者。平均年龄为 12.27 岁，性别比为 3.28。ADHD 诊断时的平均年龄为 6.6 岁。18/30 例为 ADHD 混合型，7/30 例为多动/冲动型，5/30 例为注意力不集中型。报告癫痫疾病发生率为 20%（3/6 例癫痫先于 ADHD 诊断，3/6 例平均 3.67 年后出现）。癫痫发作的平均年龄为 7 岁。发作类型为全身性（4/6 例为运动性，1/6 例为失神性）和局灶性（1/6 例）。脑电图显示 30%有癫痫样放电，以额部和左侧优势为主。发作间期放电与发病年龄较小（p：0.02）、注意力不集中型（p：0.04）和智力障碍（p：0.04）显著相关。这些放电与癫痫无关。
我们的研究结果表明，癫痫样放电可作为癫痫发作和认知障碍的危险因素，可能影响 ADHD 人群的预后。
