Attention Deficit Hyperactivity Disorder Handbook: A Physician's Guide to ADHD by J. Gordon Millichap

Author:J. Gordon Millichap
Language: eng
Format: mobi
ISBN: 1441913963
Publisher: Springer
Published: 2009-11-30T22:00:00+00:00

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7

Tics, Tourette Syndrome, Seizures, and Headaches

of external events on the headaches. Attention and emphasis by the family on

headache-free days can be a strong treatment reinforcer in children, focusing less

attention on the symptom (Marcon and Labbe, 1990). Adding a developmental perspective to psychological interventions in the management of childhood headache

is likely to increase treatment effectiveness.

Summary

Tics and Tourette syndrome, seizures, and headaches are occasional neurological

complications of ADHD and its treatment. One in 4 school children with Tourette

syndrome (TS) has ADHD, and stimulant therapy is the precipitant in 25% of

comorbid cases. Of children treated with stimulants for ADHD by pediatric neurol-

ogists, 5% develop tics. TS is usually mild, and control with medication is required

in less than half the cases encountered with ADHD. The association of TS with

ADHD is a significant predictor of learning disabilities. A non-stimulant medication

is preferred treatment for ADHD complicated by TS, and when possible, stimulants

should be avoided or used in low dosage. Clonidine and guanfacine (Tenex R

) are

alternative therapies that may be indicated in resistant cases.

Epilepsy is frequently complicated by ADHD, and children with ADHD have

a high incidence of subclinical epileptiform discharges in the EEG, especially

centro-temporal spikes. Children with ADHD and abnormal EEG have an increased

risk of seizures during treatment with stimulants. In children with comorbid

epilepsy/ADHD whose seizures are controlled with antiepileptic medication, the

introduction of stimulant therapy is safe and without risk of seizure recurrence.

Headache in children with ADHD may be precipitated by tension related

to learning disability at school, irregular meals, and stimulant medications.

Recommended interventions include a diagnostic evaluation, academic accommo-

dations, a headache diary, elimination of food items known to trigger headache, and

modification of dosage and type of ADHD medication.

References

Abu-Arefeh I, Russell G. Prevalence of headache and migraine in schoolchildren. BMJ.

1994;309:765–769.

Abwender DA, Como PG, Kurlan R, et al. School problems in Tourette’s syndrome. Arch Neurol.

1996;53:509–511.

Baumgardner TL, Singer HS, Denckla MB, et al. Corpus callosum morphology in children with

Tourette syndrome and attention deficit hyperactivity disorder. Neurology. 1996;47:477–482.

Biederman J, Melmed RD, Patel A, et al. A randomized, double-blind, placebo-controlled study

of guanfacine extended release in children and adolescents with attention-deficit/hyperactivity

disorder. Pediatrics. 2008;121:e73–e84.

Caine ED, et al. Tourette’s syndrome in Monroe County school children. Neurology. 1988;38:

472–475.

Carlsson J. Prevalence of headache in schoolchildren: Relation to family and school factors. Acta Paediatr. 1996;85:692–696.

Carter AS, et al. A prospective longitudinal study of Gilles de la Tourette’s syndrome. J Am Acad Child Adolesc Psychiatry. 1994;33:377–385.

References

95

Castaneda-Cabrero C, Lorenzo-Sanz G, Caro-Martinez E, et al. Electroencephalographic alter-

ations in children with attention deficit hyperactivity disorder. Rev Neurol. 2003;37:904–908.

Chappell PB, Riddle MA, et al. Guanfacine treatment of comorbid attention-deficit hyperac-

tivity disorder and Tourette’s syndrome. J Am Acad Child Adolesc Psychiatry. 1995;34:

1140–1146.

Eapen V, Moriarty J, Robertson MM. Stimulus induced behaviors in Tourette’s syndrome. J Neurol

Neurosurg Psychiatry. 1994;57:853–855.

Eapen V, et al. Sex of parent transmission effect in Tourette’s syndrome: evidence for earlier

age at onset in maternally transmitted cases suggests a genomic imprinting effect. Neurology.

1997;48:934–937.

Fonseca LC, Tedrus GM, de Moraes C, de Vincente Machado A, de Almeida MP, de

Oliveira DO. Epileptiform abnormalities and quantitative EEG in children with attention-

deficit/hyperactivity disorder. Arq Neuropsiquiatr. 2008;66:462–467.

Gadow KD, Sverd J, Nolan EE, Sprafkion J, Schneider J.

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