title: Levetiracetam reduces the frequency of interictal epileptiform discharges during NREM sleep in children with ADHD.
abstract: BACKGROUND
  Symptoms of attention deficit hyperactivity disorder (ADHD) are more common in children with epilepsy than in the general paediatric population. Epileptiform discharges in EEG may be seen in children with ADHD also in those without seizure disorders. Sleep enhances these discharges which may be suppressed by levetiracetam.
  
  
  OBJECTIVE
  To assess the effect of levetiracetam on focal epileptiform discharges during sleep in children with ADHD.
  
  
  METHODS
  In this retrospective study a new semi-automatic quantitative method based on the calculation of spike index in 24-h ambulatory EEG recordings was applied. Thirty-five ADHD children, 17 with focal epilepsy, one with generalised epilepsy, and 17 with no seizure disorder were evaluated. Follow-up 24-h EEG recordings were performed after a median time of four months.
  
  
  RESULTS
  Mean spike index was 50 prior to levetiracetam treatment and 21 during treatment. Seventeen children had no focal interictal epileptiform discharges in EEG at follow-up. Five children had a more than 50% reduction in spike index. Thus, a more than 50% reduction in spike index was found in 22/35 children (63%). Out of these an improved behaviour was noticed in 13 children (59%).
  
  
  CONCLUSIONS
  This study shows that treatment with levetiracetam reduces interictal epileptiform discharges in children with ADHD. There is a complex relationship between epilepsy, ADHD and epileptiform activity, why it is a need for prospective studies in larger sample sizes, also to ascertain clinical benefits.
authors.affiliation: National Centre for Epilepsy, Oslo University Hospital, Oslo, Norway. kristin_andersen_bakke@hotmail.com
authors.forename: Kristin A
authors.initials: KA
authors.lastname: Bakke
authors.forename: Pål G
authors.initials: PG
authors.lastname: Larsson
authors.forename: Ann-Sofie
authors.initials: AS
authors.lastname: Eriksson
authors.forename: Orvar
authors.initials: O
authors.lastname: Eeg-Olofsson
mesh_terms: D000927:Anticonvulsants / Q000494:pharmacology / Q000627:therapeutic use*; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications*; D002648:Child; D004569:Electroencephalography; D004827:Epilepsy / Q000188:drug therapy* / Q000209:etiology*; D005260:Female; D006801:Humans; D000077287:Levetiracetam; D008297:Male; D010889:Piracetam / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use; D012189:Retrospective Studies; D012894:Sleep Stages / Q000187:drug effects*; D014851:Wakefulness / Q000187:drug effects
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam