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.