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Epilepsy
Outpatients
Information about outpatient clinics for the assessment and management of complex and refractory epilepsy.
The Department will periodically contact patients waiting for an outpatient clinic appointment via SMS, with a link to an electronic form. This is part of routine waitlist auditing to ensure patient details are up to date. If you receive this SMS, please update your details.
Availability
North
Refer to neurology clinics.
North West
North West Regional Hospital
Phone: 6493 6300
Fax: 6464 1928
South
Royal Hobart Hospital (Level 3, B Block)
Neurology Department
Phone: 03 6166 8323
Fax: 03 6173 0292
Emergency conditions
Emergency
Emergency conditions/symptoms include (not an exhaustive list), proceed to Emergency Department:
- Status epilepticus; single prolonged seizure (over five minutes) or recurrent seizures without regaining consciousness between seizures
- Epileptic patient vomiting or too unwell to take medication
- Epilepsy with significant fever
Urgent
Urgent conditions/symptoms include:
- Persistent severe postictal headache
- Worsening of postictal mental state
- Pregnancy
Urgent referrals should be accompanied by a phone call, as per below.
Emergency care
If you, or someone else, are experiencing a serious and life-threatening injury or illness call triple zero (000) immediately or go to the nearest Emergency Department.
Learn more about when to access emergency care and non-emergency care options if the injury or illness is not serious or life-threatening.
Scope
North
Epilepsy is seen in Neurology Clinics.
North West
North West runs an Epilepsy Clinic once a fortnight either face to face or Tele health.
South
For chronic and drug-resistant epilepsy.
Most first seizures and routine epilepsy cases are seen in the general Neurology Clinic.
Referral process
A referral (preferably faxed) is required for all new appointments and must conform to the referral standards.
Please ask witness to co-attend or be reachable by telephone.
Referral history should include:
- Reason for referral: the complexity, chronicity, uncontrolled seizures, change in pattern
- Medications currently taking
- Medications previously tried, their doses and reason for stopping
- Witness description of events (and asking a witness to co-attend or be reachable by telephone)
- It is preferable the patient and significant others keep a seizure diary.
Provide:
- CT scan or MRI if indicated e.g. focal deficit postictally, persistent altered mental state postictally, fever, recent trauma, persistent severe headache
- Drug levels if pregnant, on contraceptive pill and lamotrigine, intermittent compliance is suspected, toxicity is suspect or the patient is on phenytoin (in general, levels outside parameters have limited role in management).
- A request for an EEG (fax 6173 0292) if the patient has not had one before, events are frequent, their nature is uncertain, it is many years since they have had one or they are seizure free for 10 years and seek a commercial driver's licence.
All referrals are triaged and allocated according to clinical guidelines as urgent or non-urgent. A written referral stated urgent does not guarantee urgent attention.
Appointments are based on clinical priority.
Where available, eReferral via HealthLink smart forms is now the preferred and only secure method of referral to the Tasmanian Department of Health.
Clinic appointments
Urgent (Category 1)
Urgent referrals should be accompanied by a phone call, as per below.
If you would like to discuss a patient for advice or you feel they need earlier review, please contact the Neurology Registrar directly within hours via the RHH switchboard (03 6166 8308).
We will endeavour to see these patients within four weeks, or sooner if clinically indicated.
Routine (Category 3)
Next available appointment.
Additional information
Epilepsy and driving
Most patients with epilepsy don't require specialist review for assessment of fitness to drive, and most assessments can be completed by a general practitioner.
The guidelines are clear and are available in Assessing Fitness to Drive, 4th edition, produced by Austroads. This is available on the Austroads website.
Specialist assessment is typically required for initial assessment for a commercial license, or when exceptional circumstances apply (i.e. if patient's condition or circumstances are not specifically covered by guidelines, or there is doubt about the patient's fitness to drive.
