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Question 2 Should a child with ADHD and epilepsy be given Ritalin?
  1. Caroline Boyes
  1. Correspondence to Caroline Boyes, General Paediatrics, Bradford Royal Infirmary, Bradford, West Yorkshire, UK; carolineboyes{at}doctors.net.uk

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Scenario

A 10-year-old boy with well controlled epilepsy on sodium valproate attends your clinic. On a previous clinic visit his mother complained that he was hyperactive, impulsive and could not concentrate. This was affecting his school work. You sent Conners' Questionnaires to his parents and the school, and asked the attention deficit hyperactivity disorder (ADHD) nurse to observe him in school. The results of these investigations are strongly suggestive of a diagnosis of ADHD. You would like to treat him with methylphenidate (MPH) because you know this works well in other children. However, you remember reading some National Institute for Health and Clinical Excellence (NICE) guidance that suggests caution when treating children with epilepsy with psychostimulants. What should you do?

Structured clinical question

In a child with epilepsy and ADHD [patient], does methylphenidate (MPH) …

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