Referral received by Learning Disability (LD) Services – follow core pathway

Assessment by LD Clinicians *Decision on investigations; *Review current treatment; *Review any changes to existing treatment

*Diagnosis/assessments/investigations; *risk checklist; *Epilepsy Assessment

Commence appropriate

pathway

Mental health, challenging

behaviours, Autism

Suspected Epilepsy

Investigations *Record of test results; *Disorders to consider; *Seizure recording checklist

Epilepsy Pathway supporting documents

Secondary Care Services, known Epilepsy or suspected Epilepsy

GP Referrals *new onset seizures *suspected seizures

*known Epilepsy requiring review

Allocation to Epilepsy Pathway

Referral from Childrens Services

Paediatrics

Referral to appropriate

service

Alternative causes of seizure e.g. metabolic,

cardiac, etc

Review and Diagnosis

Not Epilepsy Epilepsy Further

assessment of symptoms needed

Yes No

Discharge back to GP

Refer to appropriate service e.g.

mental health etc

Provide information/training:

*Seizure Diary Template, *Information Leaflets, *Epilepsy Awareness Training,

*Rectal Diazepam Training, *Buccal Midazolam Training,

*Rescue Medication Template, *Charity Links

Discuss Treatment Options:

*Choice of AED’s; *Rescue medication; *Considers issues of capacity to

understand choices; *GEOS; *Management Plan;

Outpatient reviews of progress; include other clinicians involved; review document and guidance; GEOS, review seizure diary, review medication, Vitamin D and Bone Health, AEDs and Osteoporosis

Well-controlled Epilepsy, treatment

well tolerated

Refractory Epilepsy

Complex Epilepsy with associated mental health/

challenging behaviours

Outpatient monitoring by LD team, discharge to GP if patient remains

stable

Review diagnosis, review treatment including

compliance, MDT input, consider second opinion from epilepsy clinic. Consider all therapeutic options eg VNS:

Training on VNS

Review diagnoses, review treatment including

compliance. MDT input. Link in with appropriate care

pathways e.g. Mental Health, Autism. Consider second

opinions from Epilepsy clinic