Advertisement

Methylphenidate and Continuous Spike and Wave During Sleep in a Child With Attention Deficit Hyperactivity Disorder

      Abstract

      Attention-deficit/hyperactivity disorder is the most common neurobehavioral disorder in children and frequently associated with epilepsy. For patients with both conditions, methylphenidate remains a mainstay in the treatment of behavioral problems. Most studies demonstrate that methylphenidate is effective in treating children with well-controlled epilepsy, and that methylphenidate does not increase the risk of having seizures in patients with EEG abnormalities without epilepsy. However, in patients with active seizures, the results are somewhat contradictory. This article presents the case of a young girl with attention-deficit/hyperactivity disorder and behavioral problems on Depakote (valproic acid) who had an abnormal EEG with left centroparietal spikes but no history of electrographic seizures. She experienced a convulsion the day after her first dose of methylphenidate, and repeat EEG demonstrated continuous spike and slow wave during sleep. This case report suggests that children with continuous spike and slow wave during sleep may have a higher risk of developing seizures with methylphenidate treatment.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Pediatric Neurology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Dunn D.W.
        • Austin J.K.
        Differential diagnosis and treatment of psychiatric disorders in children and adolescents with epilepsy.
        Epilepsy Behav. 2004; 5: S10-S17
        • Feldman H.
        • Crumrine P.
        • Handen B.L.
        • Alvin R.
        • Teodori J.
        Methylphenidate in children with seizures and attention-deficit disorder.
        Am J Dis Child. 1989; 143: 1081-1086
        • van der Feltz-Cornelis C.M.
        • Aldenkamp A.P.
        Effectiveness and safety of MPH in adult attention deficit hyperactivity disorder in patients with epilepsy: An open treatment trial.
        Epilepsy Behav. 2006; 8: 659-662
        • Hughes J.R.
        • Deleo A.J.
        • Melyn M.A.
        The electroencephalogram in attention deficit-hyperactivity disorder: Emphasis on epileptiform discharges.
        Epilepsy Behav. 2000; 1: 271-277
        • Patry G.
        • Lyagoubi S.
        • Tassinari C.A.
        Subclinical “electrical status epilepticus” induced by sleep in children. A clinical and electroencephalographic study of six cases.
        Arch Neurol. 1971; 24: 242-252
        • Beaumanoir A.
        The Landau-Kleffner syndrome.
        in: Roger J. Bureau M. Dravet C. Dreifuss F.E. Perret A. Wolf P. Epileptic syndromes in infancy, childhood, and adolescence. John Libbey, London1992: 231-244
        • Nickels K.
        • Wirrell E.
        Electrical status epilepticus in sleep.
        Semin Pediatr Neurol. 2008; 15: 50-60
        • Hergüner M.O.
        • Incecik F.
        • Altunbaşak S.
        • Kiriş N.
        Clinical characteristics of 10 patients with continuous spikes and waves during slow sleep syndrome.
        Pediatr Neurol. 2008; 38: 411-414
        • Praline J.
        • Barthez M.A.
        • Castelnau P.
        • et al.
        Atypical language impairment in two siblings: Relationship with electrical status epilepticus during slow wave sleep.
        J Neurol Sci. 2006; 249: 166-171
        • Castañeda-Cabrero C.
        • Lorenzo-Sanz G.
        • Caro-Martínez E.
        • et al.
        Electroencephalographic alterations in children with attention deficit hyperactivity disorder.
        Rev Neurol. 2003; 37: 904-908
        • Finck S.
        • Hirsch E.
        • Danion-Grilliat A.
        • Metz-Lutz M.N.
        • Marescaux C.
        Methylphenidate treatment of attention deficit hyperactivity disorder in children with continuous spikes and waves during slow sleep (CSWS).
        in: Beaumanoir A. Bureau M. Deonna T. Mira L. Tassinari C.A. Continuous spikes and waves during slow sleep. Electrical status epilepticus during slow sleep. John Libbey, London1995: 161-163
        • Tan M.
        • Appleton R.
        Attention deficit hyperactivity disorder, MPH and epilepsy.
        Arch Dis Child. 2005; 90: 57-59
        • Gucuyener K.
        • Erdemoglu A.K.
        • Senol S.
        • Serdaroglu A.
        • Soysal S.
        • Kockar A.I.
        Use of MPH for attention-deficit hyperactivity disorder in patients with epilepsy or electroencephalographic abnormalities.
        J Child Neurol. 2003; 18: 109-112
        • Gara L.
        • Roberts W.
        Adverse response to MPH in combination with valproic acid.
        J Child Adolesc Psychopharmacol. 2000; 10: 39-43
        • Moore J.L.
        • Mcauley J.W.
        • Long L.
        • Bornstein R.
        An evaluation of the effects of methylphenidate on outcomes in adult epilepsy patients.
        Epilepsy Behav. 2002; 3: 92-95