People with Epilepsy (PWE) and Attention Deficit Hyperactive Disorder (ADHD)/Attention Deficit Disorder (ADD)
Syed Muhammad Owais1, Fahham Asghar1, Hira Pervez1, Sidra Saleem1, Sumayya Naz1, Ajaz Sheikh1, Naeem Mahfooz1, Joyeta Razzaque1, Rabia Zubair1, Bashar Saour1, Anum Riaz1, Imran Ali1
1University of Toledo
Objective:
To determine the relationship between epilepsy and ADHD/ADD 
Background:
The association between epilepsy and comorbid ADHD/ADD is still under-recognized in clinical practice, even though the well-established bidirectional connection has been noted. Studies have shown a potential relationship between focal and generalized epilepsy with ADHD/ADD.  
Design/Methods:
Patients diagnosed with epilepsy and ADD/ADHD were included in the study population from our epilepsy database (2019-present). Patients with ADHD was analyzed from the epilepsy database using SPSS software, variables were compared using chi-square test and means of groups were compared using t-test. 
Results:
There are 3025 patients in the epilepsy database out of which 237 had ADHD/ADD. About 48.6% were men and 51.4% were women. The mean age was 38.70±25.8 years in the PWE without ADHD/ADD while in the ADHD group the mean age was 32.65±20.15 (p-value <0.01). The mean age of onset of seizure in the ADHD group was 22.33±20.16 years vs 26.04±22.13 years in the PWE without ADHD/ADD group (p-value <0.05). Among the ADHD group 33.8% had focal epilepsy compared to 38.5% in the PWE without ADHD/ADD (p-value 0.164). There was an increased incidence of generalized epilepsy in the ADHD group compared to the control group (39% vs 31.9% p value <0.05). Furthermore, there was an increased correlation of Childhood Absence Epilepsy (CAE) in the ADHD group (21.5% vs 6.1% p-value <0.001). EEG data was available for 180 patients in the ADHD group out of which 54 showed epileptiform changes compared to 1388 in the PWE without ADHD/ADD, out of which 183 showed epileptiform changes (30% vs 13.1% p-value 0.08).  
Conclusions:

In this study, patients with ADHD have a higher incidence of generalized epilepsy and more specifically CAE. Our study strengthens the point that ADHD is significantly associated with childhood absence epilepsy. 

10.1212/WNL.0000000000205697