Acute GP service

First Seizure clinic

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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. 

 

Please include

 

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

 

Investigations: 

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.