MYY Ngan, BCH Tsang, KL Kwong

Abstract

Introduction: Attention deficit hyperactivity disorder (ADHD) is the most common psychiatric comorbidity amongst children with epilepsy. We identified the prevalence, risk factors associated with ADHD and the impact of ADHD on seizure outcome in Hong Kong children with recent onset epilepsy. Methods: Children aged 6-18 years old with recent onset epilepsy with follow up in a regional hospital were recruited. Chinese Strengths and Weaknesses of ADHD-Symptoms and Normal-Behaviours Questionnaire was administered. Children with ADHD scores above cut-off were compared to those below cut-off for identification of demographic and seizure related variables. Results: Forty-eight children with recent onset epilepsy were recruited. Ten (20.8%) had ADHD scores above cut-off. Younger age at seizure onset (OR 1.41, 95% CI 1.05-1.88, p=0.009) and younger age at time of study (OR 1.32, 95% CI 1.01-1.73, p=0.009) were significant risk factors for ADHD. ADHD was not associated with seizure outcome, discontinuation of anticonvulsant or need of polytherapy. Conclusions: There is an increased prevalence of ADHD amongst children with recent onset epilepsy compared with the general population. Screening for ADHD in children with recent onset epilepsy is recommended.

背景：注意力不足／過度活躍（ADHD）是兒童癲癇的最常見心理併發症。作者從近期癲癇起病的香港兒童中，找出跟ADHD相關的發病情況、風險因素、及其對驚厥所造成的影響。方法：收集病例為近期癲癇起病後在當地醫院複診的6-18歲兒童。應用中文SWAN過度活躍症狀和日常行為量表進行評估。比較ADHD評分高於和低於分界值兒童的一般資料和驚厥相關差異。結果：48例近期起病癲癇兒童納入研究。10例（20.8%）ADHD評分高於分界值。驚厥發病低年齡(OR 1.41, 95% CI 1.05 - 1.88, p=0.009)和研究時低年齡(OR 1.32, 95% CI 1.01 - 1.73, p=0.009)，均為ADHD的顯著危險因素。ADHD不影響驚厥的結局、抗驚厥藥物停藥、或多藥物治療的需要。結論：對比普通人群，近期起病癲癇兒童中ADHD發病率增高。建議對近期起病癲癇兒童進行ADHD篩查。