Patients can be referred to the Scottish Epilepsy Centre for:
• Diagnostic clarification where difficulties exist.
• Prolonged in-patient video telemetry and ambulatory EEG monitoring.
• Review of treatment in a safe healthcare environment.
• Management review of complex epilepsies.
• Functional assessment to inform future care needs.
• Specific psychological evaluations and interventions.
• Nurse Specialist outreach service.
• Continued medical care for people with severe epilepsy.
The reasons for referral can be where:
• usual monitoring techniques have failed to secure a diagnosis:
• there are multiple event types, where events resolve on hospital admission, or when events are too sparse to capture in the context of a 5 day admission
• drug changes need to take place in the context of high seizure frequency and patient vulnerability, in particular where patients are on multiple AED, and where patients with a diagnosis of psychogenic events have risk factors for epilepsy and may be high risk.
• behavioural factors (usually in the context of learning disability) preclude standard video EEG monitoring, the unit can provide expert clinical monitoring and CCTV footage of attacks (the unit is CCTV monitored throughout public areas).
• Where epilepsy is accompanied by behavioural issues, particularly when the two interact
• When it is unclear how much seizure activity is going on
• When usual measures have not allowed confidence in patient compliance with AED
• Where pseudoseizures are diagnosed, the unit psychologist can also provide a specialist assessment and formulation, with recommendation for management.
Sources of referral:
Referrals can be accepted from consultants associated with epilepsy care. We may also accept referrals from other medical practitioners where there is a difficulty accessing appropriate services locally
All referrals to the Centre are reviewed by Scottish Epilepsy Centre clinical staff and multi disciplinary team prior to admission.
All referrals require support, approval and funding from the appropriate NHS authority.
If you have a patient you would like to refer to the Scottish Epilepsy Centre, please refer in writing to the Consultant Neurologist, William Quarrier Scottish Epilepsy Centre, 20 St Kenneth Drive, Glasgow.
Alternatively you can contact the Scottish Epilepsy Centre directly on telephone no: 0141 445 7755 (24 hours).
What the Scottish Epilepsy Centre offers to patients with epilepsy:
• Establish and substantiate diagnosis of epilepsy
• Initiate optimal pharmacotherapy for epilepsy
• Withdraw sub-optimal pharmacotherapy in a safe in-patient setting
• Rationalise pharmacotherapy
• Promptly deal with adverse effects of medications
• Address psychological and cognitive issues by the centre’s psychology service
• Identify and address behavioural issues in patients with epilepsy with or without learning difficulties
• Provide simultaneous multi-disciplinary care with input from neurologists, neurophysiologists, nurses, psychologists and support staff
What the Scottish Epilepsy Centre offers patients with psychogenic non-epileptic seizures PNES:
• Establish and substantiate the diagnosis of PNES
• Ensure safe withdrawal of anti-epilepsy medications
• Identify and address psychological, cognitive and behavioural issues
• Initiate psychological therapy
• Establish clear strategies for management of patients’ PNES in the community and minimisation of unnecessary utilisation of health care resources in the community and in hospitals.
In Patient Admissions length
The service design is established to provide medium term admissions (2-8 weeks average around 4 weeks) to facilitate complex assessments unsuitable for short term intervention available in specialist NHS neurological assessment services.
Prior to admission the length of assessment is planned in agreement with a Specialist Consultant and the referring NHS Health Board.
A number of variant factors influence the actual admission period. For patients assessed for diagnostic or clarification assessment the inpatient stay can be dependent on patient experiencing the variety of events that require clarification. In addition these events may need captured on EEG and/ or video to ensure accuracy of evaluation. In addition individual therapeutic responses to medication changes can be a factor.
Where extensions are required over pre agreed timescale, authority is sought by funding NHS board.