Epilepsy Information

American Epilepsy Society Poster (Abst. 2.020)

Gender differences and ADHD among children with epilepsy

Authors: Robert Trobliger, M. Lancman and Marcelo Lancman

Media attention has been given to the question of overdiagnosis of ADHD among children and with such overmedication or significant side effects. This is concerning given reports of 69% of children with ADHD taking medication. Prior research on gender differences among the general population has suggested different prevalence rates among boys and girls. Prior research has also suggested different presentations, with girls having lower ratings on inattention, hyperactivity, and impulsivity measures. Some credence has been given that boys are overdiagnosed, given that certain aspects of ADHD (including high energy levels) are more associated with boys. This raises concerns that some boys may be medicated unnecessarily. This study examined gender differences among children with epilepsy on a screening of ADHD symptoms, with an eye towards the question of overdiagnosis and impact on treatment.


Parental observations of levels of ADHD symptoms were assessed using the Conners 3 Parent. A total of 218 cases of children with diagnoses of epilepsy were included, with 110 males and 108 females. All subjects had a history of epileptogenic activity on EEG studies. The mean age was 11.27 years, with a range of 6 to 18. Gender differences in percentages rated to have significant ADHD symptomology were computed using Chi Square analysis with SPSS.

Significant findings were noted between genders. A significant difference was seen between boys and girls among those meeting criteria for ADHD. Boys were 13.1% more likely to be rated by their parents as meeting criteria, with nearly a half of boys versus nearly a third of girls rated at significant levels. A significant difference was also noted between boys and girls among those with significant criteria of hyperactivity/impulsivity symptoms. Boys were 18.9% more likely to be rated by their parents as meeting criteria, with nearly a third of boys versus approximately 1/10th of girls rated with significant symptomology. No significant gender difference was noted between boys and girls on parent ratings of inattention symptomology.

Given the significant gender differences noted on measures of hyperactivity/impulsivity, this research raises questions however regarding the possibility of pathologization of behaviors normally associated with boys. This in turn raises concerns regarding overmedication. An increase in prevalence rates over the years, combined with increase in medication of children with ADHD raises concerns regarding the effects of such. These concerns are particularly salient for boys. Some studies have suggested that a combination of medication and therapy is the best approach for treatment. Others have suggested that behavior therapy - by itself or with a small dosage of medication - is more effective than medication therapy alone. Still other work has suggested that medication is less effective over time. More research needs to be focused on behavior therapy and the message communicated to the public - that therapy can be effective, which can address concerns regarding the effects of taking medications.