Treatment outcome following the transition to adult epilepsy care in childhood-onset epilepsy

Introduction: Transition from pediatric to adult epilepsy care in patients with childhood-onset epilepsy can be challenging, and several aspects should be considered, including comorbidities, achieving social milestones, and adjustment of anti-seizure medications (ASMs). However, there is limited information regarding the treatment outcome following the transition to adult epilepsy care in childhood-onset epilepsy. Materials and methods:We performed a 13-year retrospective study of patients with childhood-onset epilepsy who had been transferred to our adult epilepsy clinic. Treatment outcomes were divided into two groups: seizure improvement (at least 50% reduction of seizure) and stationary or worsening seizures. Results:Among the 2,365 patients in our epilepsy cohort, 140 with childhood-onset epilepsy were transferred to adult epilepsy care. Forty-nine patients (35.0%) experienced improvement of seizures, whereas 91 patients (65.0%) reported stationary or worsening seizures following transition. Patients in the improvement group were younger at the time of transition than patients in the stationary or worsening group (p = 0.004) and had a lower number of ASMs before the adjustment (p = 0.001). Interestingly, patients in the improvement group had a greater chance of epileptiform discharges on EEG than patients in the stationary or worsening group (38/49 vs 54/91, p = 0.03). Conclusion:Our study shows that one-third of patients having childhood-onset epilepsy can experience seizure improvement following transition to adult epilepsy care, and the presence of epileptiform discharges on EEG may not necessarily mean a poor prognosis or drug-resistant epilepsy following the transition.