Epilepsies in children, young people and adults

Ensure that all children, young people and adults with suspected or confirmed epilepsy have access to a tertiary epilepsy service, if needed, via their specialist.

Take into account that people with suspected or confirmed epilepsy and a learning disability, physical disability or mental health problem may need additional specialist support to manage their epilepsy. Support them to access a tertiary epilepsy service if needed.

Refer people with epilepsy to a tertiary epilepsy service, to be seen within 4 weeks, if any of the following apply:

• uncertainty about the diagnosis or cause of epilepsy, the seizure type or epilepsy syndrome

• the person has an epilepsy syndrome likely to be drug resistant, their seizures are drug resistant or their treatment is associated with intolerable side effects

• further assessment and treatment approaches are indicated, such as: video electroencephalogram (EEG) telemetry, neuropsychology or neuropsychiatry, specialised neuroimaging, specialised treatments (for example, medication that can only be prescribed by a tertiary epilepsy service or a ketogenic diet), epilepsy surgery or vagus nerve stimulation

• the person is eligible for and wishes to participate in a clinical trial or research study.

Refer children with suspected or confirmed epilepsy to a tertiary paediatric epilepsy service to be seen within 2 weeks, if they:

• are aged under 3 years

• are aged under 4 years and have myoclonic seizures (see recommendation 5.4.1 in the section on myoclonic seizures)

• have a unilateral structural lesion

• are showing deterioration in their behaviour, speech or learning.