Acute GP service
This is a site intended for clinicians - all guidelines must be interpreted in the context of clinical risk assessment
First Seizure clinic
The First Seizure Clinic is based at the Royal Cornwall Hospital and runs twice a month. This is for patients with no history of epilepsy who have an event/black out which the referring GP feels is likely to be a fit.
• Refer to neurology via a paper referral to Dr Mclean, Consultant Neurologist.
• Inform patient of driving regulations and safety issues.
• Suspected cardiac syncope should be referred to cardiology.
• If a tumour is suspected please request an urgent MRI and if confirmatory, direct referral to the Derriford Neuro-oncology MDT will save time.
History of the event: what happened, when and possible triggers. Witness history is very important, so please ask a witness to attend the appointment, or provide a written account.
Any history of alcohol or drug misuse
Glucose, FBC, U&E , LFTs, Ca, Mg, ESR only help if clinically indicated.
Pregnancy test if necessary - Being pregnant is no bar to referral, but helpful to say
Neurological examination is usually unhelpful if there are no symptoms to suggest an underlying structural problem, but a cardiac assessment is useful to exclude a conduction problem.
Hypoglycaemia, hypoxia and trauma/concussion can cause a seizure in people who do not have epilepsy and may not always need neurological investigation.
An EEG is only appropriate as a secondary care investigation, and imaging will depend on the likelihood of focal epilepsy.