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