Authors' objectives:

This report aims to provide guidelines on the diagnosis and management of the epilepsies in adults and children in primary and secondary care.

Authors' recommendations: Diagnosis - All individuals with a recent onset suspected seizure should be seen urgently by a specialist. This is to ensure precise and early diagnosis and initiation of therapy as appropriate to their needs. - The seizure type(s) and epilepsy syndrome, aetiology and co-morbidity should be determined. Management - Healthcare professionals should adopt a consulting style that enables the individual with epilepsy, and their family and/or carers as appropriate, to participate as partners in all decisions about their healthcare, and take fully into account their race, culture and any specific needs. - All individuals with epilepsy should have a comprehensive care plan that is agreed between the individuals, their family and/or carers as appropriate, and primary and secondary care providers. - The AED (anti-epileptic drug) treatment strategy should be individualised according to the seizure type, epilepsy syndrome, comedication and co-morbidity, the individuals lifestyle, and the preferences of the individual, their family and/or carers as appropriate. Review and referral - All individuals with epilepsy should have a regular structured review. In children, this review should be carried out at least yearly (but may be between 3 and 12 months by arrangement) by a specialist. In adults, this review should be carried out at least yearly by either a generalist or a specialist, depending on how well the epilepsy is controlled and/or the presence of specific lifestyle issues. - At the review, individuals should have access to: written and visual information; counselling services; information about voluntary organisations; epilepsy specialist nurses; timely and appropriate investigations; referral to tertiary services, including surgery if appropriate. - If seizures are not controlled and/or there is diagnostic uncertainty or treatment failure, individuals should be referred to tertiary services soon for further assessment. Special considerations for women of childbearing potential - Women with epilepsy and their partners, as appropriate, must be given accurate information and counselling about contraception, conception, pregnancy, caring for children, breastfeeding and menopause.

Authors' methods: Clinical guideline

Project Status: Completed

URL for project: http://www.nice.org.uk/page.aspx?o=227586

Year Published: 2004

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England, United Kingdom

Organisation Name: National Institute for Clinical Excellence

Contact Address: MidCity Place, 71 High Holborn, London WC1V 6NA, UK. Tel: +44 020 7067 5800; Fax: +44 020 7067 5801

Contact Name: nice@nice.nhs.uk

Contact Email: nice@nice.nhs.uk

Copyright: National Institute for Clinical Excellence (NICE)