Journal of Pediatric Epilepsy 2020; 09(04): 150-155
DOI: 10.1055/s-0040-1716866
Review Article

Managing Transition of Care in Adolescent Females with Epilepsy

Roohi Katyal
1   Department of Neurology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, United States
,
Divya Singhal
2   Department of Neurology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
› Author Affiliations

Abstract

Transition of care from pediatric epilepsy clinics to adult health care is often a challenging process, especially due to limited availability of relevant guidelines. It carries even more significant implications in specific population subsets such as adolescent females, given a myriad of physiological as well as psychosocial changes seen in this age group. Women with epilepsy face distinct challenges because of hormonal variations on seizures (catamenial epilepsy). Furthermore, seizures and antiepileptic drugs impact menstruation, pregnancy, and lactation. These patients are at a higher risk for developing mental health problems, and a close follow-up with appropriate screening for psychiatric disorders is prudent.

Several factors contributing to poor transition of care include limited availability of a multidisciplinary set-up and social-support services, delayed referral to specialist(s), and tendency for treatment nonadherence. In this review, we discuss the current scenario of transition of care in adolescent females with epilepsy and explore avenues for improvement based on our subspecialty clinic experiences. We illustrate the value of interdisciplinary care proactively involving neurologists/epileptologists, primary care physicians, obstetricians–gynecologists, and relevant social services and emphasize shared decision-making, effective contraceptive methods, preconceptual counseling, maintenance of bone-health, and enhanced quality of life.



Publication History

Received: 29 July 2020

Accepted: 06 August 2020

Article published online:
23 September 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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