title: 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.
authors.affiliation: Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Volney L
authors.initials: VL
authors.lastname: Sheen
authors.forename: Maithreyi
authors.initials: M
authors.lastname: Shankar
authors.forename: Isaac
authors.initials: I
authors.lastname: Marin-Valencia
authors.forename: Carolyn H
authors.initials: CH
authors.lastname: Bridgemohan
authors.forename: Alcy R
authors.initials: AR
authors.lastname: Torres
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D000697:Central Nervous System Stimulants / Q000009:adverse effects*; D002648:Child; D005260:Female; D006801:Humans; D008774:Methylphenidate / Q000009:adverse effects*; D012640:Seizures / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology*; D012890:Sleep / Q000187:drug effects / Q000502:physiology*
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate