Epilepsy in the teenager

Epilepsy is the most common chronic neurological disease in adolescence and at this time may change for a number of reasons, including the natural history of the epilepsy syndrome, the underlying cause and the effect of a changing lifestyle, and specifically one that is endeavouring to achieve independence and self-empowerment. Management begins with making the correct diagnosis of epilepsy, the seizure type(s) and the epilepsy syndrome and ensuring that an underlying cause has been considered and appropriately investigated. Holistic management is mandatory but frequently difficult in view of the challenging issues at this time of life. A teenager’s adherence with management (anticonvulsants, clinical attendance and communication) is often brittle and fragile; healthcare professionals must understand this and possess the necessary skills to optimise their care and support their successful maturation into adulthood. These must include medical and communication (listening as well as talking) skills. Finally, the young person with epilepsy should be seen in an appropriate environment and their ongoing care should be electively planned, ideally through a specialised transitional service.