Yonsei Med J.  2012 Jul;53(4):806-811. 10.3349/ymj.2012.53.4.806.

Parent-Reported Symptoms of Attention Deficit Hyperactivity Disorder in Children with Intermittent Exotropia before and after Strabismus Surgery

• Chung SA
• Chang YH
• Rhiu S
• Lew H
• Lee JB

• KMID: 1716882
• DOI: http://doi.org/10.3349/ymj.2012.53.4.806

Abstract

PURPOSE
To investigate the symptoms of attention deficit hyperactivity disorder (ADHD) as reported by parents in children with intermittent exotropia [X(T)] and to determine whether strabismus surgery for X(T) affects ADHD symptoms.
MATERIALS AND METHODS
Fifty-one consecutive children undergoing muscle surgery for X(T) were prospectively recruited. One parent of each child completed the ADHD rating scale IV (ADHD RS-IV) assessment consecutively before and one year after surgery. Patients whose preoperative scores were above the cut-off point, the 90th percentile based on a Korean sample, were regarded as demonstrating the ADHD trait. The impact of muscle surgery on ADHD symptoms was assessed by comparing the preoperative scores with the post-operative scores.
RESULTS
Eight (15.7%) of the 51 patients demonstrated the ADHD trait. ADHD RS-IV scores following strabismus surgery significantly decreased in patients with the ADHD trait (p=0.014), while they did not differ in patients without the ADHD trait. Seven (87.5%) of the 8 patients with the ADHD trait showed improvement in their ADHD RS-IV scores after surgery. There was no difference in surgical success rates between X(T) patients with and without the ADHD trait.
CONCLUSION
The ADHD trait was relatively common in children with X(T), and the parent-reported symptoms of the children with the ADHD trait improved after strabismus surgery. These results suggest that childhood X(T) may be one contributing factor to ADHD-related symptoms.

Keyword

Attention deficit hyperactivity disorder; intermittent exotropia; strabismus surgery

MeSH Terms

Attention Deficit Disorder with Hyperactivity/*diagnosis
Child
Child, Preschool
Exotropia/*physiopathology
Female
Humans
Male
*Parents
Strabismus/*surgery

Figure

• 

  Fig. 1 Box and whisker plots of scores on the ADHD rating scale based on DSM-IV diagnostic criteria (ADHD RS-IV) for exotropic children who had the ADHD trait and for those who did not. The scores were assessed before surgery (dark box) and one year after surgery (bright box). (A) Total ADHD RS-IV scores. (B) ADHD RS-IV scores in inattention. (C) ADHD RS-IV scores in hyperactivity. ADHD, attention deficit hyperactivity disorder; X(T), intermittent exotropia.

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