The transition from pediatric to adult care for youth with epilepsy: Basic biological, sociological, and psychological issues.

Détails

ID Serval
serval:BIB_7599B667BF6B
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
The transition from pediatric to adult care for youth with epilepsy: Basic biological, sociological, and psychological issues.
Périodique
Epilepsy & behavior
Auteur(s)
Camfield P., Camfield C., Busiah K., Cohen D., Pack A., Nabbout R.
ISSN
1525-5069 (Electronic)
ISSN-L
1525-5050
Statut éditorial
Publié
Date de publication
04/2017
Peer-reviewed
Oui
Volume
69
Pages
170-176
Langue
anglais
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Résumé
Transition from pediatric to adult health care for adolescents with epilepsy is challenging for the patient, family, and health care workers. This paper is the first of three that summarize the main findings from the 2nd Symposium on Transition in Epilepsies, held in Paris from June 14-25, 2016. In this paper we describe five basic themes that have an important effect on transition. First, there are important brain changes in adolescence that leave an imbalance between risk taking and pleasure seeking behaviors and frontal executive function compared with adults. Second, puberty is a major change during the transition age. The three most important but separate neuroendocrine axes involved in puberty are gonadarche (activation of the gonads), adrenarche (activation of adrenal androgen production), and activation of the growth hormone-insulin like growth factor. Third, sexual debut occurs during the transition years, and at an earlier age in adolescents with epilepsy than controls. Adult sexual performance is often unsatisfactory. Although AED-induced alterations in sexual hormones and temporal lobe epilepsy may play a role in hyposexuality, depression, anxiety, and other social factors appear most important. Fourth, psychological development is very important with an evolution from an early stage (ages 10-13years) with concrete thinking, to a middle stage (ages 14-17) with analytic and more abstract introspective thinking, and then to a late stage (ages 18-21) with at least the beginnings of adult reasoning. Epilepsy may derail this relatively orderly progression. Adolescents with autistic spectrum disorder may present with severe behavior problems that are sometimes related to undiagnosed epilepsy. Fifth, bone health in adolescence is critical to establish adequate mineralization for all of adult life. While AED interference with Vitamin D metabolism is important, there is evidence that the effects of AEDs on bone are more complex and involve changes in remodeling. Hence, some non-inducing AEDs may have a significant effect on bone health. All five of these themes lead to recommendations for how to approach adolescents and young adults during transition and some specific interventions to achieve maximum long-term adult independence and quality of life.
Mots-clé
Adolescent, Adult, Child, Congresses as Topic, Epilepsy/psychology, Epilepsy/therapy, Humans, Interpersonal Relations, Quality of Life/psychology, Risk-Taking, Sexual Behavior/psychology, Transition to Adult Care/trends, Young Adult, Adolescence, Brain development, Endocrine, Epilepsy, Psychological and sociological changes, Transition
Pubmed
Web of science
Création de la notice
28/02/2020 16:04
Dernière modification de la notice
26/03/2020 6:26
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