Impact of Relationship of Epilepsy and Attention Deficit Hyperactive Disorder
Condition: Attention-Deficit Hyperactivity Disorder; Epilepsy
MeSH terms: Epilepsy; Attention Deficit Disorder with Hyperactivity
Study type: Observational

Summary: 
      The most common neuropsychiatric disorder in early childhood is attention
      deficit/hyperactivity disorder (ADHD) with evidence of abnormality in structure and function
      of brain. Epilepsy is one of the commonest comorbidity associated with ADHD with negative
      outcome on childrens' quality of life, and is considered to be a risk for academic
      underachievement. These two disorders are highly associated, with more possibility to be a
      bidirectional relationship. The mechanisms of this comorbidity are unknown. In this
      association, a difficult challenge is presented since antiepileptic therapy and drugs used to
      treat ADHD may aggravate the clinical picture of each other. The main objectives are to
      evaluate this overlap of those disorders, find their complications on child and his family,
      and to suggest possible solutions to improve the outcome of those children.
    

Detailed description: 
      The commonest childhood disorder is attention deficit hyperactivity disorder(ADHD) which
      continues into adulthood.The main two symptoms are inattention and hyperactivity.

      As epilepsy is one of the commonest comorbidity with ADHD to about (40%), there are many
      overlap symptoms between both disorders for example:

        -  Behavioral features which are shared in both frontal lobe epilepsy with ADHD such as
           impulsivity, disinhibition, and irritability

        -  The electroencephalogram: there is an increase in the rate of spikes in children with
           ADHD with no epileptic symptoms, which supports the theory of presence similar mechanism
           about central nervous system dysfunction.

      These reasons lead to increase obstacles for diagnosis, assessment, and treatment for both
      disorders.

      As this comorbidity duplicates the complications (i.e. drop the school, financial cost,
      stress on families, negative effect on academic, vocational, social relations and self-esteem
      ) so there is a great need to study this comorbidity to give a proper care for these
      patients.

      In this study, all participants will be enrolled over a period of 12 months from Assiut
      outpatients clinic .All participants will be assessed in the psychiatric interview by using
      prepared child and adolescent psychiatric sheet include (psychiatric and neurology history,
      physical examination and mental state examination). After that electroencephalogram(EEG) will
      be done to diagnoses epilepsy and identify different types of seizures.

      All participants will be categorizing into 4 groups ( ADHD, epilepsy, ADHD,and epilepsy,
      healthy) according to EEG and the psychiatric sheet. Each group will be assessed by different
      psychometrics scales to evaluate cognitive, social, economic and behavioral outcome. The
      results of all groups will be analysed by using Stata version 15 to evaluate the effect of
      ADHD and epilepsy in children and adolescent and identify the possible risk factors to
      improve outcome
    

Intervention name(s): electroencephalography; psychometric scales to diagnosis psychiatric disorders; psychometric scales for assesment socioeconomic and behaviour problems
Intervention type(s): Diagnostic Test; Diagnostic Test; Other
Intervention description(s): diagnosis epileptic discharge; to diagnosis intellectual disability, attention deficit hyperactivity disorder ,epilepsy,autism and other mental illness.; to assessment other behavioural comorbidity as aggression ,mood changes,etc and help in identify function impairment, social and economic burden
Other intervention name(s): EEG; WISC III (Wechsler Intelligence Scale for Children),conners 3rd Edition,(cbcl)The Child Behavior Checklis,Epilepsy interview,The Childhood Autism Spectrum Test (CAST); socioeconomic class, pediatric quality of life inventory, The Strengths and Difficulties Questionnaire (SDQ),The Mood and Feelings Questionnaire (MFQ),
Observational model: Case-Control
Time perspective: Retrospective
Sampling method: Probability Sample
Study population: 
        childern and adolescent attending psychiatric outpatients clinic of Assiut university who
        had diagnosis of attention deficit hyperactivity disorder or epilepsy or both and with age
        (6y-11y)