Seizures Presenting as ADHD: A Case Report

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.