A teenager epilepsy clinic: observational study

Teenagers with epilepsy are a group with special needs whom we have specifically targeted in our clinical practice. All teenagers referred to our unit between 1997 and 2001 with definite or probable epilepsy, were considered for assessment by an adult neurologist and paediatric neurologist working together in a dedicated monthly clinic. A total of 207 patients aged 11-22 (mean 16.0) years, 95 male, were seen over 46 months. Epilepsy was our diagnosis in 173 (84%), classified as generalized (n=76), focal (n=70), or unclassified (n=27). Four others had had single seizures. 'Non-epilepsy' diagnoses (n=30) included vasovagal syncope in 17, non-epileptic attack disorder in six, and migraine in three; epilepsy had been erroneously diagnosed previously in eight of these. Existing antiepileptic drug treatment, or lack of it, was considered appropriate in 165 of the 207 patients. Major changes to medication made in 42 patients included new prescriptions for those previously untreated (n=28), changing type of medication (n=6), and stopping medication (n=8). Antiepileptic medication was withheld in 21 despite epilepsy or single seizure. All patients received appropriate advice on driving, contraception, and alcohol, and were offered further specialist nurse appointments. Of the 86 females on antiepileptic medication at the time of consultation, only 12 were already taking folate supplements. The clinic had an important role in confirming diagnosis, ensuring appropriate management, information provision and aiding seamless transition to adult epilepsy care.