Epilepsy and ADHD
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition that affects attention, activity level, and impulse control.
ADHD is more common in people with epilepsy than in the general population. It is the most common co-occurring condition in children with epilepsy. Studies suggest that 30 out of 100 children with epilepsy have ADHD, a rate that is 2.5 to 5.5 times higher than the general population. Children may be at greater risk if they started having seizures at a younger age, have developmental or intellectual disabilities, or if their seizures are difficult to control.
Types of ADHD
Healthcare providers classify ADHD into three presentations:
- Predominantly inattentive
- Predominantly hyperactive-impulsive
- Combined
Children with epilepsy are more likely to have inattentive or combined presentation of ADHD.
Inattentive ADHD
People with predominantly inattentive ADHD may have difficulty:
- Paying attention to details
- Avoiding careless mistakes
- Staying focused
- Listening
- Following instructions
- Staying organized
- Completing tasks that require sustained mental effort
- Keeping track of belongings
- Resisting distractions
- Remembering things while doing daily activities
Hyperactive-Impulsive ADHD
People with predominantly hyperactive-impulsive ADHD may have difficulty:
- Sitting still
- Avoiding fidgeting
- Remaining seated when expected
- Excessive running or climbing (usually seen in children)
- Feeling extremely restless (usually seen in adults)
- Participating quietly in activities
- Talking excessively
- Waiting until a question is finished before answering
- Waiting their turn
- Avoiding interruptions or intruding on others
Combined ADHD
People with combined ADHD have symptoms consistent with both inattentive and hyperactive-impulsive presentations.
Screening for ADHD
Experts recommend screening children with epilepsy each year at the start of school because of their higher risk. Healthcare providers may use questionnaires and other screening tools to assess attention, learning, and behavior. Parents, caregivers, and teachers may also be asked to complete standardized questionnaires.
Some anti-seizure medications can affect attention and focus. Tell your healthcare provider if your child develops attention difficulties after starting a new medication.
What can mimic ADHD?
Several conditions can cause symptoms that look like ADHD. Before making a diagnosis, healthcare providers may consider whether symptoms are related to seizures, learning challenges, sleep problems, anxiety, depression, or other factors.
Seizures
Some seizure types can cause staring episodes that may be mistaken for inattention. These include absence seizures and focal impaired consciousness seizures.
Children who are distracted or daydreaming will often respond when their name is called or when touched. Children having a seizure usually cannot respond until the seizure ends. This difference may help healthcare providers determine whether staring episodes are related to attention or seizures.
Learning Challenges
Children with learning difficulties may appear distracted, especially during schoolwork or homework. If a child is struggling in school, testing can help identify underlying learning challenges.
Sleep Problems
Ongoing sleep problems and poor sleep quality can affect focus and attention. Children who are regularly overtired may have symptoms that resemble ADHD.
Anxiety and Depression
Mental health conditions such as anxiety and depression can affect attention and focus. These conditions also commonly occur alongside ADHD.
Treating both ADHD and Epilepsy
Managing ADHD and epilepsy together can be challenging because symptoms, medications, and side effects may affect one another.
Some anti-seizure medications can worsen ADHD symptoms, while medication side effects may worsen concentration. Some people also worry that stimulant medications used to treat ADHD may trigger seizures. However, the risk appears to be very low. For most people with epilepsy, ADHD medications are both safe and effective.
It is important to work with healthcare professionals who understand both epilepsy and ADHD. They can also help create a treatment plan that addresses both conditions. Treatment often includes a combination of approaches, such as:
- Behavioral therapy or cognitive behavioral therapy
- Medication
- Skills training
- Coaching
- School accommodations
The goals of treatment are to manage symptoms, support emotional well-being, improve relationships, and help children and adults succeed at school, work, and home.
Family involvement is also important. Both epilepsy and ADHD can affect the entire family, so treatment plans should include education and support for caregivers when needed.
For children who need medication, ADHD treatments can improve focus, learning, school performance, and self-esteem.
Learn More
- For more information on ADHD, visit the National Resource Center on ADHD, a program of Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).
- Learn more about epilepsy and seizures.
Resources
Epilepsy Centers
Epilepsy centers provide you with a team of specialists to help you diagnose your epilepsy and explore treatment options.
Epilepsy Medication
Find in-depth information on anti-seizure medications so you know what to ask your doctor.
Epilepsy and Seizures Helpline
Call our Epilepsy and Seizures Helpline and talk with an epilepsy information specialist or submit a question online.
Tools & Resources
Get information, tips, and more to help you manage your epilepsy.
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