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Electroencephalographic Abnormalities in Non-epileptic Children with Attention-Deficit /Hyperactivity Disorder

Author(s): Yi-Wei Li, Hui-Ju Chen, Kun-Long Hung


Objective: Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in childhood, however few studies have investigated epileptic seizures and electroencephalographic abnormalities in children with ADHD. The aim of this study was to explore the occurrence of epileptiform discharges in children with ADHD.

Method: We enrolled children with ADHD who visited the neurology clinic of our hospital between January 2014 and June 2016, all of whom met the DSM-V criteria and underwent awake and sleep electroencephalography examinations. We excluded those with histories of intellectual disabilities, epilepsy, congenital anomalies and substance abuse. None of the patients had a history of seizures before the examination.

Results: A total of 121 patients were included (93 males, 28 females, mean age 6.9±2.5 years), of whom 28 (23.1%) had electroencephalographic abnormalities, including three (10.7%) with generalized epileptiform discharges and 25 (89.3%) with focal epileptiform discharges. The focal epileptiform discharges were most prevalent from the rolandic area (15/25), followed by the parietal area (5/25), frontal area (4/25) and occipital area (1/25). Fourteen (50%) of the 28 patients had abnormal electroencephalographic findings only during sleep recordings.

Conclusions: Electroencephalographic focal abnormalities were found in 23.1% of our patients, of which 50% appeared only during sleep recordings. We suggest that sleep and awake electroencephalography recordings should be part of the routine assessment of children with ADHD regardless of whether or not they have overt seizures or other neurological conditions. In patients who do not respond well to traditional ADHD drugs, treatment for paroxysmal electroencephalographic abnormalities may be considered.

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