3 Referral to tertiary specialist services

3 Referral to tertiary specialist services


Ensure that all children, young people and adults with suspected or confirmed epilepsy have access to a tertiary epilepsy service, if needed, via their specialist.


Take into account that people with suspected or confirmed epilepsy and a learning disability, physical disability or mental health problem may need additional specialist support to manage their epilepsy. Support them to access a tertiary epilepsy service if needed.


Refer people with epilepsy to a tertiary epilepsy service, to be seen within 4 weeks, if any of the following apply:

  • uncertainty about the diagnosis or cause of epilepsy, the seizure type or epilepsy syndrome

  • the person has an epilepsy syndrome likely to be drug resistant, their seizures are drug resistant or their treatment is associated with intolerable side effects

  • further assessment and treatment approaches are indicated, such as: video electroencephalogram (EEG) telemetry, neuropsychology or neuropsychiatry, specialised neuroimaging, specialised treatments (for example, medication that can only be prescribed by a tertiary epilepsy service or a ketogenic diet), epilepsy surgery or vagus nerve stimulation

  • the person is eligible for and wishes to participate in a clinical trial or research study.


Refer children with suspected or confirmed epilepsy to a tertiary paediatric epilepsy service to be seen within 2 weeks, if they:

For a short explanation of why the committee made these recommendations and how they might affect practice, see the rationale and impact section on referral to tertiary specialist services.

Full details of the evidence and the committee's discussion are in evidence review N: criteria for referral to specialist services.