Bearden Donald J, Shakil Sidra, O'Banion David, Ono Kim E, Drane Daniel L, Loring David W, Tarquinio Daniel C
Department of Neuropsychology, Children's Healthcare of Atlanta, Atlanta, GA, USA.
Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
Epilepsy Behav Rep. 2021 Feb 10;16:100435. doi: 10.1016/j.ebr.2021.100435. eCollection 2021.
We present data on a 10-year-old patient with drug-resistant epilepsy who was treated with methylphenidate for symptoms of attention deficit hyperactivity disorder (ADHD) that developed after she underwent surgical resection of a left frontal cortical dysplasia. . The patient's parents reported methylphenidate was helpful in improving their child's reading performance. Based on parents' report, we examined benefits of methylphenidate on our patient's cognitive problems in a controlled setting. The patient underwent a neuropsychological evaluation completed in three sessions over a five-day period. Methylphenidate was administered prior to the second testing session only and was associated with improvements in the patient's attention, executive function, processing speed, and short-term memory performances. In comparison, word-reading performance, a task less susceptible to neurological impairment, was stable over the three sessions. The patient remained seizure-free after surgery and use of methylphenidate did not reduce seizure threshold. These findings support the use of methylphenidate in treating targeted cognitive problems associated with ADHD emerging after epilepsy surgery in children.
我们报告了一名10岁耐药性癫痫患者的数据,该患者在接受左额叶皮质发育异常手术切除后出现注意力缺陷多动障碍(ADHD)症状,接受了哌甲酯治疗。患者父母报告称,哌甲酯有助于提高孩子的阅读成绩。基于父母的报告,我们在可控环境下研究了哌甲酯对该患者认知问题的益处。患者在五天内分三次接受了神经心理学评估。仅在第二次测试前服用了哌甲酯,结果显示患者的注意力、执行功能、处理速度和短期记忆表现均有所改善。相比之下,单词阅读成绩这一受神经损伤影响较小的任务在三次测试中保持稳定。患者术后无癫痫发作,使用哌甲酯也未降低癫痫阈值。这些发现支持在治疗儿童癫痫手术后出现的与ADHD相关的特定认知问题时使用哌甲酯。