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.
Keywords
transition - adolescent females - epilepsy
