Epilepsy and ADHD



Attention-deficit/hyperactivity disorder (ADHD) occurs more frequently in people with epilepsy than in the general population. ADHD is the most common co-occurring disorder in children with epilepsy. Studies suggest that 30 to 40 out of 100 children with epilepsy have ADHD, a rate that is 2.5 to 5.5 times higher than the general population. Amongst children with epilepsy, those with other developmental delays or intellectual disability and those with poor seizure control appear at the highest risk of ADHD.

As all children with epilepsy are at higher risk of developing ADHD, it is recommended that screening happens on an annual basis from the time they enter school. There are many different tools that your healthcare provider can use to screen for ADHD. This involves asking questions about your child’s learning and focus as well as having both parents and teachers complete standardized questionnaires.

Some anti-seizure medications can also affect attention. Because of this, it is important to let your healthcare provider know if your child is experiencing difficulties with their focus after a new medicine is started. 

Certain seizure types can also result in inattentive staring. These include absence seizures or focal seizures with impaired awareness. Most children who stare due to inattention will respond to calling their name or touch stimulation. Children who have a seizure that leads to staring generally cannot respond to any stimulation until the seizure ends. Trying more touch stimulation can be helpful in figuring out if the staring is due to inattention versus due to a seizure.

Children who have difficulties in learning can also have more staring episodes particularly during school or homework. For children who are struggling at school, it is important to test for underlying learning difficulties.  

Children who have sleep problems and are chronically overtired will also have difficulties with their focus and attention.

Other mental health conditions such as anxiety and depression may also manifest with difficulties in attention and focus. These disorders also often coexist with ADHD. 

Treating someone with both epilepsy and ADHD can be challenging. Some seizure medicines can make ADHD symptoms worse. Some people are concerned that stimulant medication, often used to treat ADHD, can trigger seizures. However, the likelihood of this is very low.

In most persons with epilepsy, medications to treat ADHD are both safe and effective. It is important to work with healthcare professionals who are knowledgeable about epilepsy and behavior.

A treatment plan that addresses both epilepsy and ADHD should be developed.  

Treatment options for ADHD include the following:

  • Behavioral or cognitive behavioral therapy
  • Medication
  • Skills training
  • Coaching
  • School accommodation

Help should be unique to each person to help control symptoms, cope with both disorders, improve overall psychological well-being, and manage social relationships. Family involvement is important, too. Both ADHD and epilepsy affect the family. The family’s understanding of, and confidence in managing, the impact of both disorders should be addressed in the treatment plan.

For children who require medication, these medications can be very effective at allowing your child to focus and learn to improve academic success and self-esteem. 

Authored By:

Ann Abramowitz PhD
Petrina Hollingsworth MA, MBA

on Sunday, July 29, 2018

Reviewed By:

Joseph I. Sirven MD / Patricia O. Shafer RN, MN

on Sunday, July 29, 2018


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