Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
You should consider referring a patient with temporal lobe epilepsy to a neurologist for further evaluation in several key situations:
- Seizure Recurrence: Refer urgently (within 2 weeks) if the patient experiences a seizure recurrence after a period of remission NICE NG217.
- Ongoing Seizures and Unclear Diagnosis: If seizures are ongoing despite treatment and the diagnosis remains unclear, consider an additional review of MRI scans by a specialist in paediatric or adult neuroradiology within a tertiary centre NICE NG217.
- New Features: Consider an additional MRI scan if there are new features to their epilepsy NICE NG217. This would typically warrant specialist review.
- Considering Surgery: An additional MRI scan should be considered if surgery is being considered for their epilepsy NICE NG217.
- Genetic Testing: Discuss with a neurologist or geneticist any uncertainties about whether to offer genetic testing or which tests to offer to a person with epilepsy NICE NG217.
Initial referral for a first suspected seizure, or for features strongly suggestive of epileptic seizures (such as a bitten tongue, head-turning to one side during transient loss of consciousness, or confusion following the event), should also be made urgently to a clinician with expertise in assessing first seizures and diagnosing epilepsy NICE CG109,NICE NG217.