주의력결핍-과잉행동장애를 동반한 소아 간질환자에서 Methylphenidate의 효과 및 안전성

Abstract

Purpose: Twenty percent or more of children with epilepsy may have attention deficit hyperactivity disorder (ADHD). The treatment of ADHD with epilepsy has been an important clinical issue. The aim of this study is to investigate the efficacy and safety of methylphenidate in children with epilepsy and ADHD.

Methods: The subjects were 38 children with ADHD accompanied by epilepsy diagnosed at Department of Pediatrics and Epilepsy Center, Sanggye Paik Hospital. They were examined with IQ testing and Conners scales at baseline before using methylphenidate, and follow-up study was repeated 1 year after methylphenidate. Efficacy was determined by Conners scales and IQ score results. Safety was determined by measuring changes in seizure frequency, and electroencephalographic findings.

Results: According to their parents and teachers’ reports, methylphenidate improved ADHD symptoms in 24 children (63.2%). Three of them (7.9%) showed significant improvement in IQ scores and 7 children (18.4%) revealed significant improvement in cognitive function with rising IQ scores between 10 and 15 points. There were no worsening in seizure frequency, and electroencephalographic findings after methylphenidate.

Conclusion: Methylphenidate is effective and safe treatment in children with epilepsy and ADHD, showing significant benefit on children’s behavior and academic improvement in many cases.