Age-related factors for transition from pediatric to adult care in patients with childhood-onset epilepsy in Japan: A single-center mixed-methods study

BACKGROUND: Epilepsy is a chronic neurological disorder; approximately 40 % of patients continue to experience seizures from childhood into adulthood. Transition from pediatric to adult care is a critical process that involves medical transfer and supports patient autonomy. However, Japan lacks standardized transition programs, and transition timing and processes vary widely. This study examined age-related differences in transition-related factors at a single epilepsy center in Japan. METHODS: This retrospective mixed-methods study included 55 patients with childhood-onset epilepsy (18-49 years, 32 female patients) who underwent inpatient evaluation at a specialized adult epilepsy monitoring unit. All patients received continuous care from pediatric to adult services. Participants were categorized by age at transition: ≤15 years (G1, n = 11), 16-17 years (G2, n = 6), 18-21 years (G3, n = 24), and ≥ 22 years (G4, n = 14). Electronic medical records were analyzed quantitatively and qualitatively to identify medical, psychological, and social transition-related factors. RESULTS: The mean age at transition was 19.4 years (standard deviation = 4.7). The delayed-transition group (G4) tended to have higher seizure frequency and a higher proportion of patients living in areas with fewer epileptologists. However, quantitative analysis showed no significant group differences. Qualitative analysis indicated that planned transitions were uncommon and that psychiatric and psychosocial issues were often overlooked. CONCLUSION: These findings highlight the need for continuous biopsychosocial assessment, structured information sharing between pediatric and adult services, early psychological intervention, and attention to regional disparities in epilepsy care.