癫痫患儿共患注意缺陷多动障碍的临床特点分析

目的:探讨癫痫患儿中注意缺陷多动障碍(ADHD)的检出率及其临床特点。方法:选取已确诊癫痫,且均未服用抗癫痫药的患儿119例,根据美国《精神障碍诊断与统计手册》第四版(DSM-IV)ADHD的诊断标准进行诊断、分型及分析。结果:119例癫痫患儿的ADHD检出率为41.2%,以注意缺陷为主型占多数(46.9%);全身强直-阵挛发作的患儿ADHD检出率高于失神发作、简单部分性发作、复杂部分性及部分性继发全面性发作的患儿,差异有统计学意义(P<0.05);癫痫病程超过6个月的患儿,ADHD检出率高于病程<6个月的患儿,差异有统计学意义(P<0.05);脑电图存在明确癫痫样放电的患儿ADHD检出率高于无明确癫痫样放电的患儿,差异有统计学意义(P<0.05)。结论:癫痫患儿ADHD共患率高,与其发作类型、病程及脑电图癫痫样放电有关。

Analysis of comorbidity of attention deficit with hyperactivity disorder in children with epilepsy

Objective To investigate the prevalence of attention deficit with hyperactivity disorder（ADHD） in children with epilepsy and the features of eomorbidity of ADHD in children with epilepsy. Method 119 children with epilepsy without anti - epileptic drug were enrolled. All children were diagnosed mad typed based on DSM - IV published by American Psychiatric Association. Results Of the 119 children with epilepsy,49 （41.2%） were diagnosed with ADHD, among them, predominady inattentive type （PIT）were the majority （46. 9% ）. The prevalence of ADHD in children with generalized tonic -elonie seizures was higher than that in absence seizures, simple partial seizures, complex partial seiztu~s and partial seizures secondarily generalized seizures （P 〈 0. 05 ） ;the prevalence of ADHD in chil- dren whose course of epilepsy were over 6 months was higher than those whose course were less than 6 months （ P 〈 0. 05 ） ; the prevalence of ADHD in children those there presence epileptiform discharge in electroencephalograms was higher than those without epileptlform dis- charge in electroencephalograms （ P 〈 0. 05 ）. Conclusion There is a high prevalence of ADHD in children with epilepsy,it is related to the types of seizures,course of epilepsy and epileptiform discharge in electroencephalograms.