July 13, 2023
About 20 out of every 100 adults with epilepsy may also have attention deficit/hyperactivity disorder, or ADHD, and recent research demonstrates that the risk of having ADHD increases with the number of un-controlled seizures a patient experiences.
Both conditions typically start early in life – it is estimated that 30% to 40% of children with epilepsy have ADHD. Since epilepsy is a widespread condition, affecting approximately 50 million people worldwide, researchers are working to understand this connection better.
A new study from Taiwan reveals that ADHD and epilepsy share a common genetic background and several of the same chromosomal abnormalities. The study authors suggest that both genetic and environmental factors may contribute to the development of these conditions. For instance, a family history of both epilepsy and ADHD is associated with a 40% increased risk of having both conditions. Additionally, research indicates that increased exposure to air pollution during childhood raises the likelihood of a dual diagnosis of ADHD and epilepsy.
“While limited, research suggests that adults diagnosed with epilepsy and/or ADHD may be impacted by similar factors,” said Erin Fedak Romanowski, DO, a pediatric neurologist at the University of Michigan Health C.S. Mott Children’s Hospital Comprehensive Pediatric Epilepsy Program. “It is logical that many children with ADHD and chronic epilepsy grow up to be adults with ADHD and epilepsy. Identifying and treating both conditions early is crucial for optimal outcomes.”
Let’s explore more about these two conditions and their potential connection:
Which Comes First, Epilepsy or ADHD?
The exact cause for the frequent co-occurrence of epilepsy and ADHD has not been determined, but various factors play a role. Epilepsy disrupts the brain’s electrical pattern, leading to seizures. Patients with seizures affecting the frontal lobe of the brain have a higher rate of ADHD. Furthermore, patients with uncontrolled seizures are at a greater risk of developing ADHD. The potential trigger for ADHD could be attributed to problems with the frontal lobe, electrical charges from seizures, or undiagnosed brain lesions.
A recent study from British researchers suggests that epileptic spasms in infancy may lead to ADHD symptoms later in childhood and adolescence. Severe epilepsy seizures during the first two years of a child’s life may create a pathway that subsequently results in the development of ADHD symptoms. This pathway is connected to tuberous sclerosis complex (TSC), a condition characterized by gene mutations.
“Young people with epilepsy have a higher rate of psychological disorders compared to those with other chronic disorders, including ADHD,” explained Romanowski. “The precise mechanism linking the two disorders is not completely understood. The coexistence of other developmental disorders, poor seizure control, and the use of multiple antiseizure medications can all contribute to ADHD and epilepsy.”
What Are the Symptoms of Epilepsy?
Generalized seizures can be classified into six types:
- Absence seizures
- Atonic seizures
- Tonic seizures
- Clonic seizures
- Tonic-clonic seizures
- Myoclonic seizures
The symptoms of focal onset seizures vary depending on whether the individual is awake during the seizure. Signs of a focal onset aware seizure include changes in taste, smell, or hearing, mood shifts, jerking of muscles, seeing flashing lights, dizziness, and tingling sensations. Focal onset impaired awareness seizures are characterized by staring blankly, repetitive movements, and other observable behaviors.
What Are the Symptoms of Attention Deficit Hyperactivity Disorder in Adults?
ADHD symptoms in adults may include acting impulsively, difficulties with organization and time management, poor concentration, multitasking problems, restlessness, trouble with planning, easy frustration, mood swings, difficulties following through on tasks, quick temper, and an inability to handle stress effectively.
Which Treatments Might Help Both ADHD and Epilepsy?
Methylphenidate has shown potential as a treatment for attention deficit symptoms in individuals with epilepsy, although further studies are required to determine its effectiveness for most patients. However, previous research indicates that this medication may increase the frequency of seizures. It is crucial to discuss treatment options with a doctor and avoid discontinuing any medication that successfully prevents seizures. Stopping or changing medication should only be done under medical supervision.
If ADHD symptoms are suspected, it is important to obtain a proper diagnosis regardless of age. Identifying the underlying causes of ADHD can provide more extensive treatment options. “ADHD causes may include environmental trauma, various developmental, psychiatric, endocrine, and genetic disorders,” noted Yosawitz.
Managing stress, getting sufficient sleep, and maintaining a nutritious diet are essential in preventing both epilepsy and ADHD symptoms. Making healthy lifestyle choices can be a simple yet powerful tool for gaining better control over these conditions.