ADHD

Updated 13 June 2017

Epilepsy may triple ADHD risk in kids

A Danish study found that children with epilepsy had nearly three times the risk of developing ADHD compared to children without epilepsy. It isn't known why the conditions seem to be linked.

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Children who suffer from epilepsy or fever-related seizures may face a higher risk of also having attention-deficit/hyperactivity disorder (ADHD), new Danish research suggests.

Only an association

The findings echo those of some previous research. But, US experts said the new study is notable because of the large number of study participants – nearly 1 million – and the length of follow-up, which was up to 22 years.

The study looked at children born in Denmark from 1990 through 2007, tracking them until 2012. The investigators found those with epilepsy seemed to have nearly three times the risk of developing ADHD compared to children without epilepsy. And children who had fever-related seizures appeared to have an almost 30 percent increased risk of ADHD.

Read: The link between ADHD and other conditions

Children with both epilepsy and fever-related seizures had a risk of ADHD more than three times higher than those without a history of either condition, the findings suggested.

The researchers only found an association, and couldn't prove cause and effect. Even so, the links held up even after the researchers took into account other factors that might have affected risk, such as birth weight and family history of neurodevelopmental disorders or epilepsy.

Neurodevelopmental condition

"The link between these conditions is not surprising," said Dr Josiane LaJoie, a paediatric neurologist at NYU Langone Comprehensive Medical Centre in New York City. "All have their root within the central nervous system."

Another paediatric expert agreed.

Read: Is ADHD linked to traumatic brain injuries?

"Overall, it strengthens the finding which people have found before," said Dr Sayed Naqvi, a paediatric neurologist and epileptologist at Nicklaus Children's Hospital in Miami.

Naqvi said he has seen the link between epilepsy and ADHD in his own patients, but not one between fever-related seizures and ADHD.

ADHD is a common neurodevelopmental condition, marked by inattention, inability to focus and impulsivity. Fever-related seizures usually involve a fever of 102 degrees Fahrenheit or above. Epilepsy is a brain disorder that causes seizures.

Decline in school performance

It isn't known why the conditions seem to be linked. However, the researchers speculated that common genetic risk factors might help explain the connection, among other possibilities. The three conditions share some other risk factors, including low birth weight and family history.

Read: Is ADHD a disease or not?

The study has limitations, Naqvi said, and the researchers addressed them in the report. For instance, no information was available on the medications given to treat epilepsy, so the drugs could have affected the risk of developing ADHD, the researchers noted.

The take-home message for doctors, the Danish researchers said, is to identify ADHD early so treatment can be initiated before symptoms become problematic.

Parents of children with either epilepsy or a history of fever-related seizures should be on the lookout for possible ADHD symptoms, said Naqvi. One of the first warnings, if the child has started school, is a decline in school performance, he said. "That could be a red flag," he said.

And, LaJoie added, "It is vital that when caring for a child with epilepsy, some of the medical visit involves attention to academic achievement and psychosocial functioning."

The study was published online in the journal Paediatrics.

Read more:

What is ADHD?

Causes of ADHD

Treating ADHD

 

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ADHD Expert

Dr Renata Schoeman has been in full-time private practice as a general psychiatrist (child, adolescent and adult psychiatry) since 2008, currently based in Oude Westhof (Bellville). Renata also holds appointments as senior lecturer in Leadership (USB) and as a virtual faculty member of USB Executive Development’s Neuroleadership programme. She serves on the advisory boards of various pharmaceutical companies, as a director of the Psychiatric Management Group (PsychMG) and is the co-convenor of the South African Society of Psychiatrist (SASOP) special interest group for adult ADHD, and co-founder of the Goldilocks and The Bear Foundation (www.gb4adhd.co.za) She is passionate about corporate mental health awareness and uses her neuroscience background to assist leaders in equipping them to become balanced, healthy and dynamic leaders that take their own and their team’s emotional, intellectual, social health and physical needs into account. Renata is academically active and enjoys research and collaborative work, has published in many peer-reviewed journals, and has presented at local and international congresses. She is regularly invited to present at conferences and to engage with the media. During her post-graduate studies, she trained at Harvard, Boston in neurocognition and neuroimaging. Her awards include, amongst others, the Young Minds in Psychiatry award from the American Psychiatric Association, the Discovery Foundation Fellowship award, a Thuthuka award from the NRF, and a MRC Fellowship. She also received the Top MBA student award and the Director’s award from USB for 2015. She was a finalist for the Businesswomen’s Association of South Africa’s Businesswoman of the Year Award for 2016, and received the Excellence in Media Work award from SASOP during 2016.

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