Diagnosis and treatment

Our services

First seizure service

You can be referred by your GP or directly from the emergency department to our first seizure clinic. This is led by a consultant neurologist, who will review your medical information and send you for tests if needed.

  • If epilepsy is not the cause of your seizure, you will be discharged to your GP, or referred to a different health professional.
  • If the cause is uncertain, you will have a follow up with the neurologist or an specialist epilepsy nurse. Please see epilepsy nursing service for more information.
  • If epilepsy is diagnosed, after discussion, treatment may begin and you will have follow up appointments with the neurologist or specialist epilepsy nurse.

You can find out more in our first seizure patient information leaflet.

Complex epilepsy service

We assess and manage people with complex epilepsy. We can provide 24 hour inpatient monitoring on the neuromedical wards or, when necessary, in the 13 bedded neuro-intensive care unit. Our facilities also include a video-telemetry suite.

We will work closely with your GP, and you will have regular reviews with the team until your seizures have become more manageable or stopped.

Diagnosis 

There is no single test to diagnose epilepsy. We often confirm it based on a description of your seizure (best provided by someone who witnessed it), combined with your medical history and an examination of your nervous system. We will also give you a medical examination to rule out other causes for your seizure.

There are other investigations that we might use alongside this, such as an EEG (electroencephalogram) or a brain scan which can support our findings and help us to understand the cause of your epilepsy.

Investigations

We can perform the following investigations for people with epilepsy:

  • electroencephalogram (EEG)
  • ambulatory EEG
  • inpatient EEG (24, 48 or 72 hours)
  • video-telemetry
  • intra-cranial video EEG.

The National Institute for Clinical Excellence (NICE) recommends that an EEG should only be performed 'to support a diagnosis of epilepsy in adults where the clinical history suggests the seizure is likely to be epileptic in origin'.

Treatment

Epilepsy surgery

For people who find their epilepsy cannot be controlled with medication, it may be worth considering epilepsy surgery.

Vagal nerve stimulation (VNS)

VNS involves implanting a device to send small electrical impulses to the vagus nerve in the neck. Pulses are delivered to where the seizures are thought to start in the brain. This may be considered for people who haven't adequately responded to several anti-epileptic medications or are thought to have epilepsy that is difficult to treat. Read more here.