Outpatient Services (Epilepsy)
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First Seizure Clinic
Anyone with a suspected first seizure can be referred either by their GP, the A&E department at St George’s hospital, or by the medical team if they were an in-patient at St George’s Hospital, using our using our First Fit Referral Form (see the Leaflets section). The form also contains some additional information, including safety information, which the doctor should give to you at the time of making the referral. We aim to see all first fit referrals within 2 weeks of referral. Click here for first fit clinic referral (clinicians only).
Epilepsy Out-patient clinics
All our epilepsy specialists provide a specialist epilepsy service for the local population and a tertiary service for South West London, Surrey, and beyond. Patients will be seen as new referrals for suspected epilepsy, for follow up if they are known to have epilepsy and need specialist advice, for the diagnosis of functional non-epileptic attack disorder, and for second opinions from our partner district general hospitals. This includes a flexible open review service, which aims to provide advice to patients and/or GPs when it is needed, including by telephone and other means, rather than on a fixed out-patient model, which is often unsuitable for what can be an inherently unpredictable condition.
Vagal Nerve Stimulator Clinic
This clinic is dedicated to the follow up of patients who have had a VNS implanted for seizure control. Changes to the VNS settings are made and follow up is tailored to individual needs.
Epilepsy Nurse Specialist Clinics
We have two full-time epilepsy nurse specialists who provide invaluable support for our patients with epilepsy. Both nurse specialists see patients in clinic, but also hold telephone clinics and have a telephone and email contact for all our patients who need to get in touch between appointments. This gives our service the flexibility it needs to truly address the varied needs of our patients.
Our highly experienced midwife and epilepsy nurse specialist run this nurse-led clinic that focuses entirely on the needs of women with epilepsy during their pregnancy. This service is available to women with epilepsy who are known to one of the St George’s Epilepsy Consultants, and are planning to deliver their baby at St George’s.
Local patients previously under the care of paediatric neurology services at St George’s transitioning to adult services for their epilepsy care will usually be offered a transition clinic appointment to support streamlined handover of care. This is attended by members of both their paediatric team and their new adult team. A learning disability psychiatrist is invited to attend with patients with learning disability. Transition clinics run 4 times a year, and accept referrals only from St George’s Paediatric neurology and neurodisability consultants.
Tuberous Sclerosis Clinic
Professor Cock provides adult epilepsy support for the supra-regional tuberous sclerosis service. This is a multi-system disorder often complicated by epilepsy. Initial assessments are usually undertaken in a specialist multidisciplinary clinic together with colleagues from genetics and renal medicine. Longer term follow up may be in the regular epilepsy clinics, or in local services depending on individual circumstances.
Concerns about memory, organisation or other aspects of thinking in people with epilepsy are not uncommon. Where required, our consultants may request a neuropsychology referral. Our Specialist clinical Neuropsychologist oversees detailed assessments, often taking 3-4 hours. Assessment helps define strengths and weaknesses, providing an objective baseline of cognitive function and considers possible contributors (e.g. drugs, seizures, mood, or other brain disease). We offer preliminary advice about coping with identified difficulties, and onward referral to specialist rehabilitation or mood management services as appropriate for the individual.
Research & Clinical Trial Clinics
The epilepsy service is involved in a range of research studies. These can be evaluating new treatments, or studies to help improve our understanding of particular types of epilepsy. You can find out what studies are currently recruiting in the UK at https://ukctg.nihr.ac.uk/. Your consultant will usually anyway invite you to take part if you might be eligible, either in clinic or by writing to you. This is entirely voluntary, and whether you take part or not will not influence your clinical care or access to NHS services here.