The degree of attention deficits in children with complex partial seizures (CPS), with and without ADHD, were compared with that found in children with ADHD but without epilepsy, in a study at the Department of Educational Psychology, University of Texas, Austin. A computerized performance test (CPT), evaluating sustained attention, inhibition of response, response time, and consistency of response, was completed by 12 children with CPS and ADHD, 21 with CPS alone, 22 with ADHD alone, and 15 controls. CPT performance was unrelated to IQ scores on the WISC-R. Children with CPS and ADHD had the lowest scores on the CPT. Children with CPS had impaired sustained attention regardless of the diagnosis of ADHD. Antiepileptic medication, usually carbamazepine, taken by 78% of the patients with CPS was considered an unlikely cause of the attention deficits. Methylphenidate administered to patients with ADHD improved performance of the CPT in both the group with seizures and without. 
COMMENT. Complex partial epilepsy is associated with attention problems that interfere with learning and memory. In patients with CPE complicated by ADHD, methylphenidate has a similar beneficial effect on attention as that observed in children with ADHD without seizures.
An EEG is indicated in children with ADHD who have episodes of confusion or staring that interfere with attention and learning. Treatment with carbamazepine may be advisable before the initiation and addition of stimulant medication. CBZ-induced lowering of MPH blood levels is reported (see p. 15).