Ahmed et al. Egypt J Neurol Psychiatry Neurosurg (2022) 58:52 https://doi.org/10.1186/s41983-022-00482-w REVIEW Relationship between Attention Defcit Hyperactivity Disorder and epilepsy: a literature review Gellan K. Ahmed 1,2* , Alaa M. Darwish 1 , Hossam Khalifa 1 and Nourelhoda A. Haridy 1,3 Abstract Background: Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurological disorder. ADHD has been linked to epilepsy. Main body: ADHD was found to be present in 30–40% of epileptic children. Researchers have developed numerous theories to explain how and why ADHD and epilepsy coexist. Whether ADHD and epilepsy symptoms are caused by co-occurring psychiatric disorders or by the temporary effects of epileptic discharges or by antiepileptic medicines is critical to consider. Diagnosis and treatment of individuals with ADHD and epilepsy are complicated and challenging from the clinical base. Conclusions: Comorbidity between ADHD and epilepsy is still challenging to understand. The two diseases have a bidirectional link, so the association may not be coincidental. A disputable point is whether co-occurring ADHD and epilepsy symptoms represent a comorbid psychiatric disorder or are the epileptic discharges’ temporary effects, and are they related to antiepileptic drugs (AEDs). It is recommended to follow up with children with epilepsy or ADHD as they may develop comorbidity after a while. Keywords: Epilepsy, ADHD, Comorbidity, Comorbid psychiatric disorder, Antiepileptic drugs (AEDs) © The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Introduction Attention Defcit Hyperactivity Disorder (ADHD) is a prevalent neurological disorder that begins during childhood and is associated with structural and functional abnormalities in various brain areas [1]. Since the 1950s, ADHD has been linked to epilepsy [2]. ADHD is frequently observed in pediatric epilepsy. Pellock suggested that approximately 30% of epileptic children may have ADHD, while others have suggested that the prevalence may reach as high as 80% [3]. Many researchers have suggested that the two diseases have a bidirectional link, so the association may not be just coincidental. ADD/ADHD has been shown to increase the risk of epilepsy developing and vice versa [4]. As ADHD is one of the neurodevelopmental disorders, a possible link between ADHD and epilepsy could present. Tis link could be due to the involvement of infammation, anxiety, and stress in development of ADHD, which are common fndings in the pathogenesis of psychiatric and neurological disorders. Saccaro and colleagues reported in their narrative review an interplay between stress, anxiety, and immune dysregulation in ADHD, which had the implications of a potential disrupted neuroendocrine stress response in ADHD [5]. Teoretically, ADHD and its symptoms (such as emotion dysregulation) may expose a patient to a higher stress risk, which, in turn, reduces the individual’s threshold for experiencing subjective stress. Abnormal stress reactivity ensues, which is associated with infammatory dysregulation. On the other hand, Open Access The Egyptian Journal of Neurology, Psychiatry and Neurosurgery *Correspondence: gillankaram@aun.edu.eg 1 Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt Full list of author information is available at the end of the article