EPI Talks On Demand: The Teenage Patient with a Developmental Epileptic Encephalopathy at the Intersection of Pediatric and Adult Epilepsy Care-EPITalks

Video Transcription

Video Summary

The webinar examined the care of teenagers with developmental and epileptic encephalopathies (DEEs) as they transition from pediatric to adult epilepsy services. DEEs involve both an underlying cause that affects development and seizure or EEG activity that may further impair it. Distinguishing DEE from epileptic encephalopathy alone helps set realistic goals: seizure control may limit additional harm, but may not reverse developmental effects caused by the underlying condition.<br /><br />Presenters emphasized that transition is a valuable opportunity to revisit diagnosis. Adult clinicians should review the patient’s history with caregivers, reassess EEG and MRI findings, and consider updated genetic testing. Reanalysis of prior results may reveal new diagnoses; whole-exome or whole-genome sequencing can be useful when earlier testing was limited.<br /><br />Treatment should be tailored to the syndrome and cause. For example, certain sodium-channel medications can worsen seizures in Dravet syndrome or Lennox-Gastaut syndrome, while treatments such as cannabidiol, fenfluramine, and stiripentol require awareness of monitoring and drug interactions. Clinicians should also review medication benefits and side effects rather than changing stable regimens based on laboratory levels alone.<br /><br />Transition planning should address SUDEP, rescue plans, developmental and psychiatric comorbidities, disability support, guardianship, caregiver capacity, and future living arrangements. Patients with drug-resistant epilepsy should also be considered for dietary therapies, neuromodulation, or palliative surgery. Emerging precision treatments, including gene-targeted approaches, make continued attention to genetic diagnosis especially important.

Keywords

developmental and epileptic encephalopathies

teenage epilepsy transition

adult epilepsy services

genetic reanalysis

whole-exome sequencing

Dravet syndrome

Lennox-Gastaut syndrome

SUDEP planning

precision treatments

drug-resistant epilepsy