Abstract:

Abstract：Objective　We aimed to clarify the prevalence of attention-deficit hyperactivity disorder（ADHD） and the characteristics of clinical subtype and attention and response control assessment and the role of ADHD in quality of life in children with focal epilepsy（FEP）. Methods Totally 120 children with FEP underwent interview to identify the presence and type of DSM-Ⅳ defined ADHD；attention and response control assessment was measured by integrated visual and auditory continuous performance test （IVA-CPT）；the quality of life was evaluated in 112 cases by the Quality of Life in Epilepsy Inventory（QOLIE-31）. Results　Twenty-one cases out of 120 children with FEP met the diagnosis criteria of ADHD，the comorbidity rate being 17.5%；among FEP ADHD+ children，81%（17/21） were inattentive subtype，19%（4/21） were combined subtype but there were no hyperactivity subtype case.There was no difference in the rates of ADHD comorbidity among three groups of different therapy stages（P > 0.05）. IVA-CPT was measured in 120 children with FEP and 60 Benign epilepsy with centro-temporal spikes cases. The quotients of attention and response control from the there groups were not different（P > 0.05）. The comorbid ADHD was associated with the low quality of life，which was significantly lower in FEP ADHD+ children compared to PEP ADHD- group. Negative impact was on the total score of quality of life and cognitive subitem（P < 0.05）. Conclusion　ADHD is considerably more prevalent in children with FEP，characterized predominantly by the inattentive variant.ADHD is associated with poor quality of life，especially the negative impact on the cognitve. To treat epilepsy is beyond seizure freedom， and the ADHD comorbidity require further attention and essentail therapy.

Key words: comorbidity；attention-deficit hyperactivity disorder, clinical subtype；quality of life；focal epilepsy；children

摘要：

目的　分析注意缺陷多动障碍（ADHD）对局灶性发作癫痫（FEP）患儿生活质量的影响。方法　按照《精神障碍诊断与统计手册（第Ⅳ版）》诊断标准对2009年5月至2010年10月首都儿科研究所附属儿童医院神经科门诊及病房120例确诊为FEP患儿进行ADHD临床诊断及临床亚型分型，采用整合视听持续执行测试进行注意力及反应控制能力评估，采用癫痫患者生活质量量表（QOlIE-31），对112例患儿的生活质量进行评估。结果　120例FEP患儿中共患ADHD者21例（17.5%），其中ADHD-I型17例（81.0%），ADHD-C型4例（19.0%），无ADHD-HI型患儿。不同治疗阶段癫痫患儿其共患率差异无统计学意义（P > 0.05）。120例FEP患儿综合尺度注意力及综合尺度反应控制商数在不同治疗阶段的3组间差异均无统计学意义（P > 0.05），其中的60例良性儿童癫痫伴中央颞区棘波（BECTs）患儿上述指标在不同治疗阶段的3组间差异均无统计学意义（P > 0.05）。共患ADHD的FEP患儿生活质量及认知功能的分项值均明显低于无共患组，差异有统计学意义（P < 0.05）。结论　FEP患儿ADHD的共患率颇高，其临床亚型呈现注意力缺陷型占优的特点，ADHD导致癫痫患儿生活质量明显降低，对认知方面的负面影响尤为突出，故在治疗癫痫的过程中，应重视共患疾病的存在，并给予适当治疗。

关键词: 共患, 注意力缺陷多动障碍, 临床亚型, 生活质量, 局灶性发作癫痫, 儿童