Cognitive Function And Behavior Problems Of Children With Epilepsy And ADHD

School-age and adolescence are important stages for children’s attention and self-awareness development in an all-round way.Epilepsy(EP)and Attention Deficit Hyperactivity Disorder(ADHD)are the most common neuropsychiatric diseases in children.In recent years,the incidence and comorbidities of Epilepsy and Attention Deficit Hyperactivity Disorder(ADHD)show an increasing trend year by year.According to the statistics of the International League Against Epilepsy(ILAE),the incidence of ADHD in children with Epilepsy is between 13% and 70%,which is 2.5-5.5 times that of children without Epilepsy[1-2].As a special group,children with epilepsy are easily affected by many factors,cognitive function,behavior and mental problems and has not only increased the ADHD treatment difficulty of epileptic disease itself,also affects the prognosis,for children with cognitive function and mental health and social behavior also can cause varying degrees of damage,and even some children with symptoms will last into adulthood,further reducing the quality of life of children,affect the healthy growth of children.ObjectiveThrough the study of cognitive impairment and behavioral problems in children with epilepsy,ADHD and epilepsy comorbidities with ADHD,combined with the Wes Child Intelligence Scale(WISC-IV),event-related potential P300 examination and Conners Parent Symptom Questionnaire,the clinical classification characteristics of children with epilepsy comorbidities with ADHD,as well as the characteristics of cognitive function and behavioral problems were further explored.MethodIn strict accordance with the inclusion and exclusion criteria,a total of112 children aged 6-16 who met the diagnostic criteria for epilepsy in ILAE in 2014 or ADHD in DSM-V from October 2019 to December 2020 in the pediatric outpatient department of Cangzhou People’s Hospital were selected and divided into three groups:epilepsy group(40 cases),ADHD group(40cases),and epilepsy with ADHD group(32 cases).Meanwhile,30 healthy children aged 6-16 who underwent physical examination in the child health care outpatient department were selected as the healthy control group(hereinafter referred to as the control group).The consent of the children’s parents agreed to and signed written informed consent,please Conners parents filling out a questionnaire on the basis of the condition of the children,for all the groups tested wechsler intelligence scale for children(WISC-IV),the scale for assessment of ADHD and detection of event related potential P300 amplitude and latency.Statistics and analysis of data from clinical classification characteristics of epilepsy of children with ADHD,cognitive function and behavior characteristics.Results1.General informationThere was no significant difference in age and sex distribution among all groups(P>0.05).According to the clinical manifestations combined with the ADHD diagnostic scale,the children in the ADHD group and the epileptic group with ADHD were classified into clinical types.There were 40 cases in the ADHD group,including 16 cases of attention deficit type,6 cases of impulsive-hyperactivity type,and 18 cases of mixed type.There were 32 cases of epilepsy with ADHD,including 17 cases of attention deficit type,5cases of impulsive-hyperactivity type,and 10 cases of mixed type.2.Results of children’s Wechsler Intelligence ScaleThe scores of IQ and speech comprehension,intuitive reasoning,working memory and processing speed index in the children with epileptic co-ADHD group were lower than those in the epileptic group,ADHD group and control group,and the scores of working memory index and processing speed index were lower,the differences were statistically significant(P<0.05).Epilepsy group compared with ADHD group,group of working memory in children with epilepsy,processing speed index score below the ADHD group,the difference was statistically significant(P<0.05),intuitive reasoning index,the IQ scores below the ADHD group,there was no statistically significant difference(P>0.05),verbal comprehension index scores higher than the ADHD group,there was no statistically significant difference(P>0.05).Epilepsy group,the ADHD group compared with control group,the intelligence quotient(IQ)and speech understanding,intuitive reasoning,working memory and processing speed index four children scored lower than the control group,the difference was statistically significant(P<0.05).3.Test results of event-related potential P300Compared with the epilepsy group,the ADHD group and the control group,the incubation period of the epilepsy group was longer,and the amplitude of the epilepsy group was lower,with statistical significance(P<0.05).The incubation period of the epilepsy group was longer than that of the ADHD group,the difference was statistically significant(P<0.05),and the amplitude was decreased(P=0.732>0.05),the difference was not statistically significant.Compared with the control group,the incubation period of the epilepsy group and the ADHD group was longer,but the amplitude was lower,and the difference was statistically significant(P<0.05).4.Conners scale resultsEpilepsy in ADHD group compared with epilepsy group,ADHD,hyperactivity index,behavioral problems,learning problems,impulse and hyperactivity scores higher than that of epilepsy group,the difference was statistically significant(P<0.05),and psychosomatic problems,anxiety score higher than that of epilepsy group,there was no statistically significant difference(P>0.05).Behavioral problems,learning problems,psychosomatic problems,anxiety score higher than the ADHD group,the difference was statistically significant(P<0.05),impulse and move more and more dynamic index differences of no statistical significance(P>0.05).Epilepsy group compared with ADHD group,psychosomatic problems,anxiety,impulse and hyperactivity,hyperactivity index difference was statistically significant(P<0.05),the difference of behavioral problems and learning problems,no statistical significance(P>0.05).Epilepsy with ADHD,epilepsy group,the ADHD group compared with control group,epilepsy,ADHD with epilepsy group behavior problems,learning problems,psychosomatic problems,impuls e and restlessness,anxiety,hyperactivity index scores were higher than control group,the difference was statistically significant(P<0.05).ADHD group behavior problems,learning problems,impulse and hyperactivity,hyperactivity index score higher than the control group,the difference was statistically significant(P<0.05),the differences of psychosomatic problems,anxiety has no statistical significance(P>0.05).Conclusion1.The clinical diagnosis classification of children with co-epileptic ADHD is mainly attention deficit type,while the clinical diagnosis classificaion of children with simple ADHD is mainly mixed type,and there are certain differences between the two.2.Epilepsy and ADHD diseases themselves have certain damage to children’s cognitive function,while children with epilepsy combined with ADHD have more serious cognitive impairment than children with single epilepsy/ADHD,mainly in terms of working memory and processing speed.3.Children with epileptic co-ADHD are more likely to have developme-ntal behavioral problems,mainly manifested in two aspects of conduct disorder and learning disorder.4.Children with epilepsy comorbidities with ADHD are more likely to have cognitive impairment and behavioral problems.The Conners Parent Questionnaire is helpful for the early detection of children’s behavioral problems,and the combined application of Wechsler Intelligence Scale and Event-related Potential(P300)can further clarify the cognitive function and behavioral impairment of children,which can help clinicians to take timely and effective measures to improve the quality of life of children with specific interventions.