Norwich Children’s Epilepsy Service

Children’s Epilepsy Service

This service has developed over the last 16 years initially with Dr Richard Beach and now headed by Dr Ruchi Arora who joined the team from Great Ormond Street Hospital in 2010.

Epilepsy is the commonest serious neurological disorder affecting 1 in 200 children. Seventy percent of people who develop epilepsy do so in the first two decades of life. (SIGN, 2005).

At present there are some 300 children and young people with epilepsy under the care of the Children’s Epilepsy Clinic. This constitutes nearly all the epilepsy without disability in the local population. Consultant colleagues usually refer epilepsy patients to this clinic.

On average 70 new epilepsy cases present each year and three times that number of possible new epilepsies are seen in the Children’s Epilepsy Clinic.

There are seven epilepsy clinics each month. The service is primarily designed for children whose epilepsy is their main problem, but children with multiple disabilities are also seen. Children with complex disability are often under the care of community paediatricians who may on occasion seek specialist advice regarding their epilepsy.

The Children’s Epilepsy Service is well supported by the Children’s Epilepsy Specialist Nurse. This is a community-based post that maintains close working links with the hospital epilepsy paediatrician. There are excellent EEG services based in the Department of Neurophysiology on the NNUH site.

These are child friendly. The department is friendly and approachable. Urgent EEG investigation may be possible. There is a combined paediatric EEG meeting each month where cases are reviewed.

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Paediatric neuroimaging is well developed. MRI (and/or CT) scanning are readily available. Detailed imaging with MRV/CTV and MRA is also performed for patients with conditions like Cerebral Venous Thrombosis. Dr Duncan MacIver offers excellent radiology opinions. There are good links to adult neurology.

Dr Jeff Cochius accepts young people transferring from the children and young people’s service. The Epilepsy Nursing Team also run a transition clinic.

The overall goal of managing epilepsy is to enable the child or young person and their family to lead a life as free as possible from clinical and psychosocial complications. This is achieved through access to the Children’s Epilepsy Specialist Nurse and other associated colleagues who have effective links to schools, secondary care and other services accessed by the child and family. The particular needs of adolescents are managed in the Young Person’s Epilepsy Clinic and the nurse-led Young Person’s Epilepsy Clinic (held monthly at NNUH).

The service follows the recommendations of the National Institute for Health and Clinical Excellence (2004) and the SIGN guidelines (2005).