Editorials

The teenager with epilepsy

BMJ 1998; 317 doi: https://doi.org/10.1136/bmj.317.7164.960 (Published 10 October 1998) Cite this as: BMJ 1998;317:960

Has special needs

  1. Philip E M Smith, Consultant neurologist
  1. Epilepsy Unit, University Hospital of Wales, Heath Park, Cardiff CF4 4XW

    Even for healthy teenagers, coping with emerging adulthood is a major challenge. A chronic disability such as epilepsy simply magnifies the problems of adolescence, and the penalties for seizures at this time are far more severe than in childhood. Epilepsy and its treatment have a direct bearing on major aspects of lifestyle such as education and employment prospects, driving ability, the use of alcohol and recreational drugs, relationships, contraception, pregnancy, and parenthood. Self consciousness is paramount and deviations from peer group norms assume great importance: epilepsy can be disastrous for an adolescent's self esteem and sense of identity.

    Adolescents with epilepsy are often caught between paediatric and adult medical disciplines, with neither service specifically addressing their needs. The Liverpool group advocates multidisciplinary consultations with a neurologist, paediatric neurologist, and specialist epilepsy nurse.1 Whatever the setting, the consultation must focus on the needs and independence of the teenager, with the parents taking a back seat. If possible, part of the consultation …

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