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J R Soc Med. 2001 October; 94(10): 554.
PMCID: PMC1282233

Transition from paediatric clinic to the adult service

Adolescence is a challenging, often traumatic but fascinating time of life whether or not it is accompanied by a chronic medical disorder such as diabetes, cystic fibrosis, arthritis—or epilepsy1,2,3, a condition which is in fact more common than the three preceding disorders cited by Professor David in his somewhat pessimistic editorial (August 2001 JRSM, pp. 373-374).

In 1991 a specific ‘hand-over’ or transition clinic for teenagers with epilepsy was established in Liverpool which is supervised jointly by a paediatric and an adult neurologist (both of whom have a particular interest in epilepsy) together with a nurse specialist in epilepsy. The primary objectives of this teenager clinic are to address the unique needs and concerns of this age group and, importantly, to facilitate a smooth hand-over of specialist epilepsy care from paediatric to adult services4. The success of this clinic—as assessed by both the teenagers themselves (who have a ‘did not attend clinic’ rate of < 3%)—and the development of other similar units throughout the UK and the rest of Europe, would suggest that this approach is generally regarded as a ‘model’ service. Undoubtedly, the success of this service is largely dependent on demonstrating a clear commitment to the young people, the philosophy and personalities of the clinic staff and the teenagers themselves.

In Liverpool, and for teenagers with epilepsy, the future is bright.


1. Appleton RE. Epilepsy in the teenager. Curr Paediatr 1996;6: 88-91
2. Smith PEM. The teenager with epilepsy (has special needs). BMJ 1998;317: 960-1 [PMC free article] [PubMed]
3. Appleton RE, Neville BGR. Teenagers with epilepsy. Arch Dis Child 1999;81: 76-9 [PMC free article] [PubMed]
4. Appleton RE, Chadwick D, Sweeney A. Managing the teenager with epilepsy: paediatric to adult care. Seizure 1997;6: 27-30 [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press