Children with attention deficit hyperactivity disorder (ADHD) have an increased risk of seizures, and children with epilepsy have an increased prevalence of ADHD. Adults with epilepsy often have varying degrees of attentional dysfunction due to multiple factors, including anti-seizure medications, frequent seizures, interictal discharges, underlying lesions, and psychiatric comorbidities. Currently, there are no approved medications for the treatment of epilepsy-related attentional dysfunction. Methylphenidate (MPH) is a stimulant, FDA-approved for the treatment of ADHD, and often used for ADHD in the setting of pediatric epilepsy. Large database and registry studies indicate safety of MPH in children with ADHD and epilepsy, with no significant effect on seizure frequency. Small single-dose and open-label studies suggest efficacy of MPH in adults with epilepsy-related attention deficits. Methylphenidate represents a possible treatment for attentional dysfunction due to epilepsy, but large, randomized, placebo-controlled, double-blinded studies are needed.

中文翻译：

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哌醋甲酯治疗癫痫患者注意力问题：安全性和有效性


患有注意力缺陷多动障碍 (ADHD) 的儿童癫痫发作的风险增加，而患有癫痫的儿童 ADHD 的患病率也更高。成人癫痫患者常常因多种因素而出现不同程度的注意力障碍，包括抗癫痫药物、频繁癫痫发作、发作间期放电、潜在病变和精神合并症。目前，还没有批准的药物用于治疗癫痫相关的注意力功能障碍。哌醋甲酯 (MPH) 是一种兴奋剂，经 FDA 批准用于治疗多动症，通常用于治疗小儿癫痫的多动症。大型数据库和登记研究表明 MPH 对于 ADHD 和癫痫儿童是安全的，对癫痫发作频率没有显着影响。小规模单剂量和开放标签研究表明 MPH 对患有癫痫相关注意力缺陷的成人有效。哌醋甲酯是治疗癫痫引起的注意力功能障碍的一种可能的治疗方法，但需要进行大型、随机、安慰剂对照、双盲研究。