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 QCH 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
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