Original Article Seizures in children with epilepsy and attention-deficit/hyperactivity disorder Zeynep Goker, 1 Arzu Yilmaz, 2 Ayse Nihal Eraslan, 3 Rukiye Colak Sivri 3 and Rezzan Aydin 3 1 Department of Child Psychiatry, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, 2 Departments of Child Neurology and 3 Child Psychiatry, Ankara Training and Research Hospital, University of Health Sciences, Ankara, Turkey Abstract Background: Epilepsy is an important disorder that is sometimes accompanied by inattention problems. This study explored the features of seizures in children with epilepsy, with or without attention-deficit/hyperactivity disorder (ADHD). Methods: Between January 2017 and January 2018, data records of children with epilepsy aged 5–18 years admit- ted to hospital were retrospectively collected. SPSS 17.0 was used for analyses and P < 0.05 was accepted as signif- icant. Results: Of 301 patients with epilepsy, 32 of them had ADHD. Median age at diagnosis of epilepsy in the epilepsy + ADHD group was lower than in the epilepsy alone group (6 vs 8 years; z = À2.989, P = 0.003). The two groups were similar in terms of duration of epilepsy, seizure types and features of complicated versus non-complicated epi- lepsy, number of anti-epileptic drugs (AED) used (for all, P > 0.05). The epilepsy + ADHD group had a signifi- cantly higher prevalence of intellectual disability (31.3% vs 12.6%; v 2 (1) = 7.9, P = 0.014) and specific learning disorder (12.5% vs 1.9%; v 2 (1) = 11.1, P = 0.009) than the epilepsy alone group (v 2 (1) = 11.1, P = 0.009). ADHD medication use was identified in 68.8% of children in the epilepsy + ADHD group. Conclusion: Attention-deficit–hyperactivity disorder was identified in 11.8% of 5–18-year-old children (32/301) with epilepsy in a 1 year period. ADHD is more frequent in children with epilepsy in childhood (5–11 years of age). Epilepsy diagnosis is more frequent in younger children with ADHD. Children with epilepsy and ADHD, also have a significantly higher prevalence of intellectual disability and specific learning disorder. Younger children diagnosed with epilepsy should be carefully monitored for ADHD. Key words anti-epileptic drug, attention-deficit–hyperactivity disorder, children, epilepsy. Epilepsy is an important disorder that is sometimes accompa- nied by inattention or concentration problems. 1 This is partly due to the underlying mechanisms responsible for the sei- zures, as well as to the adverse effects of the anti-epileptic drugs (AED). 2 If epilepsy is complicated with any structural brain abnormalities, then the occurrence of mental disturbance symptoms increases to 29–58%. 3 Attention-deficit–hyperactiv- ity disorder (ADHD) is a frequently seen entity, at around 5% in childhood, 4 and its prevalence significantly increases if there is a concurrent seizure disorder, from 8% to 30–40% depending on study design, the sample studied, and the crite- ria used for diagnosis. 2,3,5 Epilepsy and ADHD both could affect a child for a long-time period in all dimensions of life if left untreated. Poor academic achievement 6 and lower quality of life have been documented in children with epi- lepsy and ADHD. 7 Understanding seizures and their relation to ADHD therefore might be helpful to improve treatment outcome. 8 The aim of this study was to evaluate seizure type and fea- tures in children aged 5–18 years with epilepsy and with or without ADHD, and compare the epilepsy alone versus epi- lepsy + ADHD groups. Methods Between January 2017 and January 2018, electronic data of the patients admitted by the Child Neurology clinics of Ankara Education and Training Hospital were screened, based on the following inclusion criteria: (i) age ≥5 years and <18 years; (ii) duration of epilepsy ≥6 months and diagnosed based on the International League Against Epilepsy (ILAE) classification criteria, 9 regardless of seizure frequency, under- lying epilepsy syndrome or ongoing AED treatment; and (iii) diagnosis of ADHD according to the Diagnostic and Statisti- cal Manual of Mental Disorders, fifth edition (DSM-5). 4 Correspondence: Zeynep Goker, MD, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Child Psychiatry Department, Sehit Omer Halisdemir Caddesi, Kurtdereli Sokak, No: 10, 06100-Dis- kapi-Ankara, Turkey. Email: zeynepgoker@hotmail.com Received 9 September 2018; revised 26 May 2019; accepted 8 July 2019. © 2019 Japan Pediatric Society Pediatrics International (2019) 61, 1043–1047 doi: 10.1111/ped.13972