Study of Patients with Centrotemporal (Rolandic) Epilepsy Aged Four to Fifteen Years that Suffer from Attention Deficit Hyperactivity Disorder

Dr. Shivali Desai ^*, Dr Vijay Kolhar¹, Dr Varsha²

1. Assistant Professor in Dept of Paediatrics, ESIC Medical College and Hospital Kalaburagi.

2. Senior Resident in Dept of Paediatrics, ESIC Medical College and Hospital Kalaburagi

*Correspondence to:  Dr. Shivali Desai, Senior Resident in Dept of Paediatrics, ESIC Medical College and Hospital Kalaburagi.

Copyright

© 2024: Dr. Shivali Desai. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: 20 Nov 2024

Published: 01 Dec 2024

Abstract

Introduction: Rolandic epilepsy (also known as benign epilepsy with centrotemporal spikes) is one of the most common focal epilepsies in childhood. Though often labeled "benign," concerns have arisen regarding its association with neurocognitive and behavioral challenges, including attention deficit hyperactivity disorder (ADHD).

Objective: This study aimed to determine the prevalence and characteristics of ADHD in children aged 4–15 diagnosed with rolandic epilepsy.

Methods: A descriptive cross-sectional study was conducted on a sample of 33 patients with typical rolandic epilepsy. Parents and teachers of these children completed the DSM-5 ADHD questionnaire and Conners scale. Data were analyzed using SPSS version 21.

Results: ADHD was identified in 36.4% of the participants, with inattentive ADHD being the most prevalent subtype. Teachers reported significantly fewer ADHD traits compared to parents. Academic difficulties were noted in nearly half the sample.

Conclusion: ADHD is a frequent comorbidity in children with rolandic epilepsy. Systematic behavioral screening during follow-up care is critical to ensure early intervention and improve outcomes.

Keywords: Rolandic epilepsy, ADHD, childhood epilepsy, neurocognitive disorders, pediatric neurology.   

Introduction

Rolandic epilepsy, often termed benign epilepsy with centrotemporal spikes, is the most prevalent focal epilepsy among children, typically appearing between ages 7 and 10. Most seizures occur during the non-rapid eye movement (NREM) sleep phase and resolve without long-term complications during adolescence. However, emerging evidence suggests potential cognitive and behavioral issues in affected children, particularly ADHD. ADHD, the most common neurobehavioral disorder in childhood, has a worldwide prevalence of 5.2%, but its incidence is notably higher in children with epilepsy.

This study explores the prevalence and characteristics of ADHD in children with rolandic epilepsy in Medellín, Colombia, based on clinical and sociodemographic factors.

Methodology

This descriptive, cross-sectional study included 33 children aged 4 to 15 years diagnosed with typical rolandic epilepsy. Participants were selected from a larger cohort involved in epilepsy genetics research. Children with atypical rolandic epilepsy, intellectual disabilities, or brain lesions were excluded.

Parents completed demographic questionnaires, the DSM-5 ADHD diagnostic tool, and the Conners scale. Teachers also provided feedback via the Conners scale and DSM-5 questionnaires. ADHD was identified when more than six positive responses were recorded on the DSM-5 or when Conners scale scores exceeded 70.

Data collection shifted to a virtual format due to the COVID-19 pandemic, and responses were analyzed using SPSS version 21.

Results

Among the 33 participants, 60.6% were female, and 24.2% had a prior ADHD diagnosis. The cumulative prevalence of ADHD, based on new diagnoses and existing cases, was 36.4%.

• Subtype distribution: Inattentive ADHD was the most common subtype, followed by the combined subtype.
• Academic challenges: Over 50% of participants experienced academic difficulties, and 18.2% had repeated a school year.
• Parental versus teacher reports: Parents identified more ADHD symptoms than teachers, a discrepancy potentially influenced by the pandemic and extended parental observation during isolation.

Table No. I Sociodemographic characteristics of a patient museum with Rolándica epilepsia (N: 33)

Figure No. I. Prevalence of ADHD in a sample of patients with Rolandic epilepsy, Medellín 2020 (N: 33)

Table II Distribution and subtype of ADHD in children with Rolandic epilepsy

According to DSM 5 survey applied to Parents, Medellín 2020 (N: 33)

Table No. III Academic impact on children with ADHD,

According to DSM 5 survey applied to parents, Medellín 2020 (N:7)

Table IV Frequency of sociodemographic and clinical characteristics of patients with rolandic epilepsy with a previous diagnosis of ADHD and according to questionnaires applied to parents and teachers (N:12)

Discussion

The findings reveal a significant overlap between rolandic epilepsy and ADHD, supporting previous research that links focal epilepsy with behavioral disorders. The inattentive ADHD subtype aligns with trends in similar studies. Academic struggles, noted in almost half the participants, highlight the broader cognitive impact of epilepsy.

Parental over-reporting during the pandemic, compared to teachers’ responses, suggests environmental influences on ADHD diagnosis. Additionally, the study's findings emphasize the need for genetic exploration, given a family history of rolandic epilepsy in 24.2% of participants.

Conclusion

ADHD is a common comorbidity in children with rolandic epilepsy, with significant implications for academic performance and social development. Comprehensive follow-up, including behavioral screening with validated tools like the DSM-5 and Conners scales, is essential. Early identification and intervention, involving multidisciplinary care, can enhance quality of life for these children.

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