HNY Policy and Pathway Repository - Humber

Children and young people (up the age of 16 years)  presenting to an Accident and Emergency department or Primary Care following a suspected seizure should be screened initially. This should be done by a physician with onward referral to a Paediatric Epilepsy Specialist when an epileptic seizure is suspected or there is diagnostic doubt.  

If history is suggestive of brain tumour, referral should be along the cancer pathway or Acute Paediatric services.

All episodes of acute symptomatic seizures (traumatic head injury, seizures associated with febrile illness) pro-longed seizures, seizures in unwell child should be referred to the Acute Paediatric services.

Exclude Red Flag Symptoms

- Suspected infantile spasm
- Daily episodes
- Seizures with Developmental regression or Neurological signs

In a child / young person presenting with an attack, a physical examination should be carried out. This should address their cardiac, neurological and mental status, and should include a developmental assessment where appropriate

Essential information on how to recognise a seizure, first aid, and the importance of reporting further attacks should be provided to a child/young person who has experienced a possible first seizure, and their family/carer/parent as appropriate. This information should be provided while the child / young person is awaiting a diagnosis.

The diagnosis of epilepsy in children and young people should be established by a specialist paediatrician with training and expertise in epilepsy.  It is recommended that all children and young people who have had a first non-febrile seizure should be seen as soon as possible by a specialist in the management of the epilepsies to ensure precise and early diagnosis and initiation of therapy as appropriate to their needs.

All children (0-16 years) with suspected epileptic seizure.

All referrals to be sent through NHS e-Referral via the paediatric epilepsy triage service.

Information To Include

- Age at onset of symptoms
- Frequency of episodes
- Event description
- Relevant medical history including developmental, learning or behavioural problems
-Family history
- Request family to maintain event diary and obtain video of episodes for clinic review

CG137 Referral algorithm

- Event Diary

- Tips on video recording an event

- Head Smart Leaflet

- NICE Guidance CG137

- What does a spasm look like?