Systematic review of the screening, diagnosis, and management of ADHD in children with epilepsy. Consensus paper of the Task Force on Comorbidities of the ILAE Pediatric Commission

被引：79

作者：

Auvin, Stephane ^{[1
]}

Wirrell, Elaine ^{[2
,3
]}

Donald, Kirsten A. ^{[4
]}

Berl, Madison ^{[5
]}

Hartmann, Hans ^{[6
]}

Valente, Kette D. ^{[7
]}

Van Bogaert, Patrick ^{[8
]}

Cross, J. Helen ^{[9
,10
]}

Osawa, Makiko ^{[11
]}

Kanemura, Hideaki ^{[12
]}

Aihara, Masao ^{[13
]}

Guerreiro, Marilisa M. ^{[14
]}

Samia, Pauline ^{[15
]}

Vinayan, Kollencheri Puthenveettil ^{[16
]}

Smith, Mary Lou ^{[17
]}

Carmant, Lionel ^{[18
]}

Kerr, Michael ^{[19
]}

Hermann, Bruce ^{[20
]}

Dunn, David ^{[21
,22
]}

Wilmshurst, Jo M. ^{[23
]}

机构：

[1] Robert Debre Univ Hosp, APHP, Dept Pediat Neurol, Paris, France

[2] Mayo Clin, Div Child & Adolescent Neurol, Rochester, MN USA

[3] Mayo Clin, Div Epilepsy, Rochester, MN USA

[4] Univ Cape Town, Red Cross War Mem Childrens Hosp, Neurosci Inst, Div Dev Paediat,Dept Paediat & Child Hlth, Cape Town, South Africa

[5] Childrens Natl Med Ctr, Div Pediat Neuropsychol, Washington, DC 20010 USA

[6] Hannover Med Sch, Clin Pediat Kidney Liver & Metab Disorders, Hannover, Germany

[7] Univ Sao Paulo, Fac Med, Inst & Dept Psychiat, Div Clin Neurophysiol,Clin Hosp HCFMUSP, Sao Paulo, Brazil

[8] Univ Hosp Angers, Dept Pediat Neurol & Neurosurg, Angers, France

[9] UCl Great Ormond St Inst Child Hlth, Dev Neurosci Programme, London, England

[10] Young Epilepsy, Lingfield, England

[11] Tokyo Womens Med Univ, Dept Pediat, Tokyo, Japan

[12] Univ Yamanashi, Fac Med, Dept Pediat, Yamanashi, Japan

[13] Univ Amanashi, Grad Sch, Grad Fac Interdisciplinary Res, Yamanashi, Japan

[14] Univ Campinas Unicamp, Dept Neurol, Campinas, Brazil

[15] Aga Khan Univ, Dept Paediat & Child Hlth, Nairobi, Kenya

[16] Amrita Inst Med Sci, Dept Neurol, Div Pediat Neurol, Cochin, Kerala, India

[17] Univ Toronto Mississauga, Hosp Sick Children, Dept Psychol, Toronto, ON, Canada

[18] Univ Montreal, CHU St Justine, Dept Neurosci & Pediat, Montreal, PQ, Canada

[19] Cardiff Univ, Div Psychol Med & Clin Neurosci, Cardiff, S Glam, Wales

[20] Univ Wisconsin, Dept Neurol, Sch Med & Publ Hlth, Madison, WI 53706 USA

[21] Indiana Univ Sch Med, Dept Psychiat, Sect Child & Adolescent Psychiat, Indianapolis, IN 46202 USA

[22] Indiana Univ Sch Med, Dept Neurol, Sect Child & Adolescent Psychiat, Indianapolis, IN 46202 USA

[23] Univ Cape Town, Red Cross War Mem Childrens Hosp, Dept Paediat & Child Hlth, Div Paediat Neurol,Neurosci Inst, Cape Town, South Africa

来源：

EPILEPSIA | 2018年 / 59卷 / 10期

关键词：

antiepileptic drug; attention-deficit/hyperactivity disorder; children; epilepsy; methylphenidate; screening tools; DEFICIT-HYPERACTIVITY DISORDER; ATTENTION-DEFICIT/HYPERACTIVITY DISORDER; CHILDHOOD-ONSET EPILEPSY; QUALITY-OF-LIFE; COGNITIVE FUNCTION; EXECUTIVE FUNCTIONS; BEHAVIORAL-PROBLEMS; ACTIVE EPILEPSY; RATING-SCALES; HEALTH-CARE;

D O I：

10.1111/epi.14549

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Attention-deficit/hyperactivity disorder (ADHD) is a common and challenging comorbidity affecting many children with epilepsy. A working group under the International League Against Epilepsy (ILAE) Pediatric Commission identified key questions on the identification and management of ADHD in children with epilepsy. Systematic reviews of the evidence to support approaches to these questions were collated and graded using criteria from the American Academy of Neurology Practice Parameter. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) requirements were followed, with PROSPERO registration (CRD42018094617). No increased risk of ADHD in boys with epilepsy compared to girls with epilepsy was found (Level A). Valproate use in pregnancy is associated with inattentiveness and hyperactivity in offspring (1 class I study), and children with intellectual and developmental disabilities are at increased risk of ADHD (Level A). Impact of early seizure onset on development of ADHD was unclear (Level U), but more evident with poor seizure control (Level B). ADHD screening should be performed from 6 years of age, or at diagnosis, and repeated annually (Level U) and reevaluated after change of antiepileptic drug (AED) (Level U). Diagnosis should involve health practitioners with expert training in ADHD (Level U). Use of the Strength and Difficulties Questionnaire screening tool is supported (Level B). Formal cognitive testing is strongly recommended in children with epilepsy who are struggling at school (Level U). Behavioral problems are more likely with polytherapy than monotherapy (Level C). Valproate can exacerbate attentional issues in children with childhood absence epilepsy (Level A). Methylphenidate is tolerated and effective in children with epilepsy (Level B). Limited evidence supports that atomoxetine is tolerated (Level C). Multidisciplinary involvement in transition and adult ADHD clinics is essential (Level U). In conclusion, although recommendations could be proposed for some of the study questions, this systematic review highlighted the need for more comprehensive and targeted large-population prospective studies.

引用

页码：1867 / 1880

页数：14

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