1. Fits, faints and Funny turns GP Refresher week
Dr Penny Mancais
Paediatric Consultant
Lead for Epilepsy

2. Learning objectives Who and when do I refer?
What investigations might I do?
How do I refer?
What is my role as a GP
Where can I go for further information.

3. Parental anxiety, pressure for a diagnosis, Epilepsy is a very emotive area,

6. May be epilepsy but more likely sncope or a non epileptic episode.

7. Who do I refer?
Before, during, after, what happens after the event, neurological ,cardiac and behaviour/development examination adds very little to making a diagnosis ( consider BP and examine back of eyes)

8. What parts of the history would reassure me?
Commonest differential is syncope
Pallor, sweaty, feels hot, change of position,
can twitch/stiffen but short lived with quick recovery.
?Epileptic:
Sudden fall, often no warning, blank stare, headache, incontinence of urine, drowsy, longer

9. What investigations might I do as a GP?
No need for any other tests

10. Who do I refer

11. How to refer in West Dorset
Patch Consultant ( 4-6 week)
On call Consultant ( babies, unwell, high level of concern)
Rapid access Clinic ( normal with in 2 weeks)
If have a diagnosis of Epilepsy already refer to Epilepsy Clinic.
Some areas have specific first seizure clincs and may be seen first of al by a neurolgist.

12. On going role for GP
Offer first Aid management,
safety advice,
diary

14. What happens at the hospital appt

15. Gps please don’t request 1:100 have abnormalities not signifcant
Gps please don’t request 1:100 have abnormalities not signifcant. Does not exclude.
Last national audit we do about 100 per year for first seizure

17. Where can I go for further information
Epilepsy Action
Young Epilepsy. Phone App.
ILAE : good for professionals
STARS. Blackout check list
NICE and SIGN
National audit of Epilepsy death and SUDEP
DVLA

20. Any questions