engleski

Transition of Patients with Epilepsy from Childhood into Adulthood

Transition is the process of preparing children and adolescents with chronic illness and their families for the adult health care system. Youth must leave the family-centered approach of pediatric care for the individual focus of adult medicine. Several clinical studies have indicated that patients with epilepsy are at risk of persistent long-term poor psychosocial outcome on several transitional domains, e.g., education and employment. However, adolescents with (chronic) epilepsy have to transfer from pediatric to adult medical care at a certain point of life. Furthermore, in patients with Lennox-Gastaut syndrome, generalized epilepsies with febrile seizures plus (Dravet syndrome, Doose syndrome), progressive myoclonus epilepsies (the commonest being Unverricht-Lundborg disease, Lafora disease, neuronal ceroid lipofuscinosis, myoclonic epilepsy with ragged red fi bers and sialidoses), and other epileptic syndromes, the process of transition is complicated by the presence of intellectual disability, treatment- resistant epilepsy, behavioral issues and in some cases disability due to cerebellar, pyramidal and extrapyramidal symptoms, as well as fatal prognosis. To cope with these problems, epilepsy transition clinics and polyclinics have been set up in the world for adolescents, especially in the last ten years, which can provide help for medical, psychosocial and developmental issues during adolescence. Several different models of epilepsy transition clinic staffing have been reported, including both neuropediatricians and adult neurologists, clinical neuropsychologists, social worker, nurse specialist, and an educationalist/vocational counselor. The presentation aims to discuss the main objectives in the transition process from the neurological aspect, i.e. to revise the previously made epilepsy/epileptic syndrome diagnosis, determined clinical phenotype and treatment options, and to transfer the adolescent to the adult health care system.

transition, epilepsy, epileptic syndrome, adolescence

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