Seizures Presenting as ADHD: A Case Report
Anies Siya K. S. *
Jawaharlal Nehru Medical College, Datta Meghe institute of Medical Sciences (DU), Sawangi (M), Wardha, Maharashtra, India.
Fadi Mohamed Kallan
Jawaharlal Nehru Medical College, Datta Meghe institute of Medical Sciences (DU), Sawangi (M), Wardha, Maharashtra, India.
Julianna Jinson Kolenchery
Jawaharlal Nehru Medical College, Datta Meghe institute of Medical Sciences (DU), Sawangi (M), Wardha, Maharashtra, India.
Vismaya Rachel D'silva
Jawaharlal Nehru Medical College, Datta Meghe institute of Medical Sciences (DU), Sawangi (M), Wardha, Maharashtra, India.
Amit B. Nagdive
Department of Psychiatry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed University), Sawangi, Wardha-442107, (Maharashtra), India.
Siddharth Sethi
Department of Psychiatry, Acharya Vinoba Bhave Rural Hospital, Datta Meghe Institute of Medical Science (DU), Sawangi (M), Wardha, Maharashtra, India.
*Author to whom correspondence should be addressed.
Abstract
ADHD (Attention Deficit Hyperactivity Disorder) is a neurodevelopmental disorder that affects a large proportion of children. ADHD is associated with an increased risk of seizures and is characterised by inattention, restlessness, and impatience.
A 6-year-old boy with ADHD presented to the Psychiatry Out-Patient Department with complaints of aggressive behaviour and restlessness. Trademark symptoms such as difficulty in sustaining concentration, not following instructions, running about, not being able to sit in one place, and verbally and physically abusive behaviour were noted in the patient.
Atomoxetine and Risperidone were prescribed for inattention and behavioural misconduct, respectively. Due to lack of improvement and a seizure suggestive incident an EEG investigation was instigated; it showed seizure activity for which Sodium Valproate was initiated for the same. Due to adverse effects, Oxcarbazepine was additionally included. Oxcarbazepine showed the most effective in treatment and progress continued with the intake of the drug. Currently, the boy is showing near total improvement and is on Atomoxetine 20 mg, Oxcarbazepine 600 mg and Sodium Valproate 400 mg, all of the above in divided doses.
This case report aims at highlighting the manifestation of unprovoked seizure activity in a patient previously diagnosed with ADHD with conduct disorder.
Several medical conditions in children mirror ADHD symptoms, making diagnosis difficult. For accurate treatment, it's crucial to rule out a differential diagnosis. With the help of this case, we can shed some light on the lack of knowledge and protocols in the management of hyperkinetic disorders, which has resulted in the spike of misdiagnosed cases across the country.
Keywords: Attention deficit hyperactivity disorder, seizures, epilepsy, generalised tonic-clonic seizures