This article describes the collaborative development of a nurse-led transition clinic within the Comprehensive Epilepsy Program at the Stollery Children's Hospital and at the University of Alberta Hospital. Developed in 2005, our program has been instrumental in assisting 97 teens and their parents' transition from pediatric to adult epilepsy care. Through our Adolescent Epilepsy Transition Clinic, we address concerns expressed by teens and their parents when shifting from pediatric to adult healthcare services, including fear of the unknown, change in appointment location, loss of established relationships, and anticipated decrease in the quality of care posttransition. We also address concerns of adult and pediatric healthcare providers related to the adolescents' working knowledge of how their particular type of epilepsy and its management interact with typical adolescent developmental challenges and future career and lifestyle choices. The results from a process evaluation are presented and offer new insights for improving adolescent transition. F or more than a decade, child health advocates have recognized that adolescents with chronic health conditions require a well-planned and coordinated transition between pediatric and adult

Objective evidence is limited for the value of transition programs for youth with chronic illness moving from pediatric to adult care; however, such programs intuitively "make sense". We describe the strengths and weaknesses of a variety of transition programs from around the world for adolescents with epilepsy. Consequences of poorly organized transition beyond suboptimal seizure control may include an increased risk of SUDEP, poor psychological and social outcome and inadequate management of comorbidities. The content of transition programs for those with normal intelligence differs from those with intellectual disability but both groups may benefit from an emphasis on sporting activities. Concerns that may interfere with optimal transition include lack of nursing or social work services, limited numbers of adult neurologists/epileptologists confident in the treatment of complex pediatric epilepsy problems, institutional financial support, and time constraints for pediatric and adult physicians who treat epilepsy and the provision of multidisciplinary care. Successful programs eventually need to rely on a several adult physicians, nurses and other key health care providers and use novel approaches to complex care. More research is needed to document the value and effectiveness of transition programs for youth with epilepsy to persuade institutions and health care professionals to support these ventures.