Çocuklarda Epilepsi ve Dikkat Eksikliği Hiperaktivite Bozukluğu Birlikteliğinin Özellikleri: Geriye Dönük İnceleme

Yıl 2019, Cilt: 17 Sayı: 1, 71 - 84, 01.04.2019

Sevim Şahin Tülay Kamaşak Elif Acar Arslan Betül Diler Durgut Beril Dilber Sema Kandil Ali Cansu

Öz

GİRİŞ ve AMAÇ: Çocuklarda, dikkat eksikliği ve hiperaktivite bozukluğu (DEHB) epilepsiye
sıklıkla eşlik etmektedir. Bu birlikteliğin nedenleri konusundaki görüşler
farklıdır. Epilepsiden önce veya sonra gelişen DEHB’de, epilepsi özelliklerinin
etkisi çalışılmamıştır. Bu çalışmada, DEHB ve epilepsi birlikteliği gösteren
çocukların verileri, bu ilişkiye yönelik ipuçları elde etmek amacıyla
incelenmiştir.

YÖNTEM ve GEREÇLER: Çocuk Nörolojisi polikliniğine ardışık olarak başvuran, epilepsi ve DEHB
birlikteliği gösteren 44 hastanın (33 erkek, 11 kız) verileri geriye dönük
olarak incelendi. Çeşitli özelliklere göre ikili alt gruplarda istatistiksel
karşılaştırma yapıldı. 

BULGULAR: DEHB 11
hastada (%25) epilepsi bulguları öncesinde, 33 hastada (%75) ise epilepsi
sonrasında tanılanmıştı. Hastaların yaş ortalaması 11,5±2,7, ilk nöbet yaşları
5,2±3, son nöbet yaşı 9,5±2,8, antiepileptik başlama yaşı 6,6±3,4, DEHB tanı
yaşı 8,4±2 yıldı. Epilepsi sonrasında DEHB tanılananlarda, antiepileptik
tedavinin başlangıç yaşı ve ilk nöbet yaşı daha küçüktü (sırasıyla, p=0,004 ve
p=0,002). İki gruptaki cinsiyet dağılımı, epilepsi tipi, DEHB tanı yaşı,
elektroensefalografi ve beyin manyetik rezonans görüntüleme bulguları benzerdi.
Epilepsi ve DEHB tanıları arasındaki sürenin anlamlı olarak kısa olduğu
hastalar; ilk nöbet yaşı >5 ve antiepileptik başlama yaşı >6,5 yaş
olanlardı (sırasıyla, p=0,013, p=0,000). Epilepsi ve DEHB tanıları arasındaki
süre 1,5 yıldan uzun olanlarda, EEG anormalliği daha sıktı (p=0,044). Son nöbet
ve AEİ başlama yaşları; DEHB tanı yaşı ile pozitif korelasyon gösterdi
(r=0,389, r=0,434, p<0,05).

TARTIŞMA ve SONUÇ: Çalışmamızda, epilepsiden önce veya sonra DEHB tanılanan hastalarda, DEHB
tanı yaşı benzer saptandı. Ancak antiepileptik ilaç gereksinimi, erken çocukluk
ve okul çağı olmak üzere, iki ayrı döneme yığılma göstermişti. Diğer epilepsi
özelliklerinin benzer olması, iki hastalığın birlikteliğinde ortak patogenetik
mekanizmaların rol oynayabileceğini düşündürmektedir. 

Anahtar Kelimeler

Çocuk, dikkat eksikliği ve hiperaktivite bozukluğu, epilepsi

Characteristics of Epilepsy and Attention Deficit Hyperactivity Disorder Comorbidity in Children: A Retrospective Analysis

Öz

INTRODUCTION: Epilepsy is
often accompanied by attention deficit hyperactivity disorder (ADHD). There are
different opinions about reasons. The effect of epilepsy features was not
studied in ADHD before or after epilepsy. We aimed to obtain clues about this
comorbidity in children. 

METHODS: Data of forty-four (33
males, 11 girls) consecutive epilepsy patients with ADHD were retrospectively
reviewed. The binary subgroups were statistically compared.

RESULTS: ADHD was
diagnosed before epilepsy in 11 (25%) and after epilepsy in 33 (75%) patients.
The mean age was 11.5±2.7, the first and last seizure ages were 5.2±3 and
9.5±2.8, antiepileptic drug (AED) starting and ADHD ages were 6.6±3.4 and 8.4±2
years respectively. In patients with ADHD after epilepsy, AED and first seizure
ages were younger (p=0.004 and p=0.002, respectively). Gender, epilepsy type,
ADHD age, electroencephalography and brain magnetic resonance imaging findings
were similar. There was a shorter interval time between ADHD and epilepsy in
patients with a first seizure age >5 and AED age >6.5 years (p=0.013 and
p=0.000). EEG abnormalities were more frequent in patients with >1.5 years
time interval between epilepsy and ADHD (p=0.044). The ages of last seizure and
AED starting ages were positively correlated with ADHD age (r=0.389, r=0.434,
p<0.05).

DISCUSSION
 and CONCLUSION: We found similar ADHD ages in patients with ADHD
before or after epilepsy. However, AEDs need was observed in two separate
periods, early childhood and school age. The similarity of other features
suggests that common pathogenetic mechanisms may play a role in this
comorbidity.

Anahtar Kelimeler

Attention deficit and hyperactivity disorder, child, epilepsy

Kaynakça

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