When faced with co-morbidities in paediatrics, many of us need to take a deep breath. It’s not really that often your off-the-street child has more than one diagnosis, is it? (And currently, you can take a 9:1 bet on the diagnosis being ‘bronchiolitis’.) So, when the question of treating a child with ADHD and epilepsy arises, there’s a pair of problems that are faced:1) guidance that suggests ‘caution’ when treating children with epilepsy with psychostimulants: but if the child’s climbing the walls, the parents are hiding under the tables and the teachers are barring the school gates, how much ‘caution’ is needed?

2) how do we acquire and appraise evidence of adverse effects, or conjunctions of rare occurrences?

These questions are in the process of being assessed by Dr Boyes in Bradford, but thoughts (as always) are welcome.