Referral guideline – Epilepsy

Introduction

Epilepsy is a group of neurological conditions characterised by recurrent epileptic seizures.

Epilepsy can take various forms in childhood and many conditions can mimic epileptic seizures.

GP management

  • Complete seizure history – onset of seizure, description of all events, response to medications or medication side effects
  • EEG (standard or sleep deprived)
  • Home video of events
  • Neuroimaging (magnetic resonance imaging [MRI] preferred
    • Early if a structural lesion is suspected
    • Non urgent if no specific cause
    • Note CT scans unnecessarily expose patients to radiation and do not adequate evaluate intraparenchymal structures

When to refer

  • GPs should refer children with suspected epilepsy to their closest general paediatric service.
  • General paediatricians should referral to LCCH neurosciences if:
    • patient has failed two or more appropriate anticonvulsant medications
    • diagnosis is complicated by comorbidities i.e. developmental delay
    • patient is under 2 years of age
    • diagnosis of epilepsy is uncertain i.e. concerns that events may be non-epileptic.

Essential referral info

  • History of events and treatments to date
  • EEG report, MRI, relevant investigations (if performed)
  • Patient details
  • Medicare number
  • Parent/carer name and contact details
  • Referring clinician details (name, contact details, provider number, date and length of referral)

Helpful referral info

  • Examination findings including ECG and BP in R arm
  • Height/weight/head circumference/percentile charts
  • Birth and developmental history
  • Medication history (including OTC)
  • Significant psychosocial risk factors

Parent service

Neurosciences

Contact details

Hospital Switchboard
(Ask for the General Paediatric Registrar)
t: 07 3068 1111

Resources

National Institute for Health Care and Clinical Excellence (NICE) Guidelines