Research Service, VA New York Harbor Healthcare System, 423 E. 23rd St., New York, NY 10010, United States; Comprehensive Epilepsy Center, Department of Neurology, New York University Langone Health, 223 E. 34th St., New York, NY 10016, United States.
Department of Psychiatry and Behavioral Sciences, 401 Quarry Road, Stanford, CA 94305-5723, United States.
Epilepsy Behav. 2021 Feb;115:107627. doi: 10.1016/j.yebeh.2020.107627. Epub 2020 Dec 24.
Children with attention deficit hyperactivity disorder (ADHD) have an increased risk of seizures, and children with epilepsy have an increased prevalence of ADHD. Adults with epilepsy often have varying degrees of attentional dysfunction due to multiple factors, including anti-seizure medications, frequent seizures, interictal discharges, underlying lesions, and psychiatric comorbidities. Currently, there are no approved medications for the treatment of epilepsy-related attentional dysfunction. Methylphenidate (MPH) is a stimulant, FDA-approved for the treatment of ADHD, and often used for ADHD in the setting of pediatric epilepsy. Large database and registry studies indicate safety of MPH in children with ADHD and epilepsy, with no significant effect on seizure frequency. Small single-dose and open-label studies suggest efficacy of MPH in adults with epilepsy-related attention deficits. Methylphenidate represents a possible treatment for attentional dysfunction due to epilepsy, but large, randomized, placebo-controlled, double-blinded studies are needed.
患有注意缺陷多动障碍（ADHD）的儿童癫痫发作风险增加，而患有癫痫的儿童 ADHD 患病率增加。由于多种因素，包括抗癫痫药物、频繁发作、发作间期放电、潜在病变和精神共病，成年癫痫患者常常存在不同程度的注意力功能障碍。目前，尚无治疗与癫痫相关的注意力障碍的批准药物。哌醋甲酯（MPH）是一种兴奋剂，FDA 批准用于治疗 ADHD，并且常用于儿科癫痫中的 ADHD 治疗。大型数据库和注册研究表明 MPH 在患有 ADHD 和癫痫的儿童中的安全性，对癫痫发作频率无明显影响。小型单剂量和开放标签研究表明 MPH 对癫痫相关注意力缺陷的疗效。哌醋甲酯可能是治疗癫痫引起的注意力障碍的一种方法，但需要进行大型、随机、安慰剂对照、双盲研究。
