Elizabeth Felton, MD, PhD

“On the adult side we typically only manage the epilepsy piece. A lot of times pediatric patients have to go to see more than one adult provider to get the same services they were getting on the pediatric side. It’s helpful if the parent and patient are aware of that… I think the transition clinic can be very helpful for that.”

An underutilized resource for easing the transition from pediatric to adult care in patients with epilepsy is transition clinics. Elizabeth Felton, MD, PhD, assistant professor of neurology at the University of Wisconsin, feels that transition clinics can significantly improve the process, ensuring good continuity of care.

Transition clinics can help package together a patient’s medical information, dietary needs, restrictions, and medications in an organized manner for the new treating physician. This may also help to improve communication between pediatric and adult epilepsy care specialists who may prioritize different aspects of care. Improved communication can help to put patients and families at ease during this stressful time, providing them with extra confidence that their medical care is being handled correctly and is being tended to appropriately.

 annual meeting of the American Epilepsy Society (AES), Felton sat down with 

 to deliver her “call to action” to her fellow epilepsy specialists on what they can do to improve the transition period for patients with epilepsy.  

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The assistant professor of neurology at the University of Wisconsin detailed the importance of transition clinics for pediatric patients with epilepsy.

Elizabeth Felton, MD, PhD: The Utility of Transition Clinics in Epilepsy 

“If a patient is going to start on childhood and continue into adulthood or if they start in adulthood and continue long term, there are a lot of things we have to watch for. There are a lot of potential side effects of a ketogenic diet.”

The side effects and lifestyle adjustments associated with the ketogenic diet can complicate the transition from pediatric to adult epilepsy care. While many pediatric patients choose to discontinue the diet as they enter adulthood, those who remain on the diet may be at risk for mineral deficiencies as well as a higher risk of osteoporosis.

In these cases, dieticians are key to maintaining good health, along with continued seizure control. A dietician can help make treatment decisions alongside an epilepsy specialist, including diet modifications, as well as periodic monitoring through bloodwork.

Elizabeth Felton, MD, PhD, assistant professor of neurology at the University of Wisconsin, spoke with 

 annual meeting of the American Epilepsy Society (AES), December 6-10, 2019, in Baltimore, Maryland, about the role that dieticians can play in the care of adult epilepsy patients who elect to remain on the ketogenic diet post-transition from pediatric care.

The assistant professor of neurology at the University of Wisconsin provided insight on the additional oversight required when caring for adult epilepsy patients who remain on the ketogenic diet.  

Elizabeth Felton, MD, PhD: Monitoring Ketogenic Diets in Adults With Epilepsy 

“The conversations around transition should really happen as early as age 11 or 12. But what we don’t have is a lot of guidance on how to do transition for ketogenic diet.”

Pediatric patients with epilepsy often struggle with the transition to adult care, as many different moving parts must be coordinated and transferred correctly to ensure continuity of care. For patients on the ketogenic diet, this transition can be especially complicated, as adult practitioners may not be as familiar with non-pharmacologic therapies or may assume that patients have a desire to transfer to more traditional treatments.

 annual meeting of the American Epilepsy Society (AES), December 6-10, 2019, in Baltimore, Maryland, Elizabeth Felton, MD, PhD, assistant professor of neurology at the University of Wisconsin, discussed her experience as an adult neurologist and epilepsy specialist with managing the transition of patients on the ketogenic diet from pediatric to adults care.

She noted the challenges that these patients often face, including assumptions about their preferred therapeutic approach, as well as the preparation that goes into seeing a new specialist and potentially switching over to a modified diet. In an interview with 

, she detailed what can be done to ensure a smoother transition.

The assistant professor of neurology at the University of Wisconsin discussed the challenges of transitioning patients on the ketogenic diet from pediatric to adult epilepsy care.

Author | Elizabeth Felton, MD, PhD

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Elizabeth Felton, MD, PhD: The Utility of Transition Clinics in Epilepsy

Elizabeth Felton, MD, PhD: Monitoring Ketogenic Diets in Adults With Epilepsy

Elizabeth Felton, MD, PhD: Ketogenic Diet Considerations in Transition to Adult Epilepsy Care