First Seizure Clinic

This is a consultant-led service for people who have had a suspected epileptic seizure. The purpose of the clinic is to ensure that all cases of suspected first seizures are seen as soon as possible in order to determine if the event was an epileptic seizure or not. Following the assessment, we may arrange appropriate investigations and treat if necessary. 

Most people will be referred to a first seizure clinic by either a doctor from the emergency department or by a GP.

An epileptic seizure is a sudden and transient burst of abnormal electrical activity in the brain. There are many different types of seizures and they can affect the way a person thinks, feels, behaves, acts and moves. The symptom and clinical features will depend on which parts of the brain are involved. In a more severe epileptic seizure, a person may lose consciousness and fall, their body may appear stiff and they may exhibit jerking movements. Tongue biting may occur. Their breathing may change and they may appear drowsy and confused after the seizure. This type of seizure is also called a “fit” or “convulsion”).

Epilepsy is a tendency to have recurrent epileptic seizures. A diagnosis of epilepsy will usually be made if a person has had two or more epileptic seizures, or if the risk of a second seizure after the first is thought to be high.

Epilepsy is a common neurological disorder. Over 600,000 people in the UK have epilepsy. There are many different types of epilepsy and it can start at any age. For some people with certain types of epilepsy their seizures will last for a limited time. For others it can be a lifelong condition. For most people, the seizures can be controlled. The most common treatment is anti-seizure medication which helps to stop seizures from happening.

The appointment will be with one of the epilepsy consultants. They will ask you to describe what happened and how you felt before, during and after your suspected seizure. You will be asked questions about your general health. Sometimes a scan of your brain called an MRI may be needed, and an EEG (electroencephalogram) which is a recording of your brain waves. You will have to come back to the hospital at a later date for these investigations.

A detailed and accurate description of what happened is the most important part of the assessment. It is really helpful if you bring a witness to the appointment, or make sure they are available to speak on the telephone. If they are not available then please ask them to write down a detailed description of what they witnessed and bring it with you to the appointment. If you have any documentation about what happened to you from the ambulance or hospital then please bring this with you as well. 

Below are common questions you may be asked:

• What you were doing before the episode started?
• Did you have a warning?
• What was the last thing you remember?
• Did you lose consciousness?
• Did your colour or breathing change?
• Were there any movements of your body, arms or legs?
• Did you bite your tongue?
• Did you wet yourself?
• How long did the episode last?
• Were you confused afterwards? 
• How long was it until you were back to yourself?
• Did you have any muscle aches or pains (myalgia) afterwards?

Many people will never have another seizure. If you do, then you should be seen in a neurology clinic as soon as possible. Your GP or the doctors in the emergency department (if you are assessed there) can arrange this for you.

If you have any more seizures before your appointment, you should attend your local emergency department. It is important to keep a record of these to discuss with the neurology team.

You should stop driving. You should take care around water and heights. It is advisable to limit your alcohol intake and avoid sleep-deprivation. Some recreational drugs such as ecstasy and cocaine can cause seizures, and these should be avoided. High alcohol intake or dependence can cause epileptic seizures, particularly alcohol withdrawal. If you have alcohol dependence which has led to a seizure then it is important to seek help for this (Integrated Camden Alcohol Service 020 3227 4950).

• Avoid bathing. Take a shower instead.
• Avoid swimming unless you are accompanied by a responsible adult or there is a lifeguard who is aware that you have had a seizure.
• Avoid heights.
• Stand well back from platform edges and roadsides when travelling.
• Use a microwave oven or the back rings on a cooker.
• Let people know where you are and when they can expect you to return.
• You should not operate heavy machinery.

You must stop driving and tell the DVLA that you have had a suspected seizure. It is your responsibility to inform the DVLA. You may be fined if you do not. You should not drive until your Neurologist has given you permission. The DVLA will make a decision based on advice from your Neurologist. More information can be found on the DVLA website (www.gov.uk).

What to do if someone has an epileptic seizure:

• Try to stay calm.
• Note the time to record how long the seizure lasts for.
• Cushion the head with a rolled-up jumper, pillow or your hands.
• Move anything away from them. 
• Try to stop others crowding around.
• Loosen tight clothing around the neck.
• Do not restrain them.
• Do not give them anything to eat or drink until they are fully recovered.
• Do not try to move them. 
• Do not put anything between their teeth or in their mouth.

When the jerking has stopped:

• Roll them on to their side and put them in the recovery position.
• Stay with them and give reassurance, explain what has happened.
• Recovery time can vary from minutes to hours. Sometimes people can be very confused or combative after a seizure.

If you have any more seizures before your appointment then you should call emergency services on 999 and attend your local emergency department.

• Epilepsy Society, 01494 601400, www.epilepsysociety.org.uk
• Epilepsy Action, 0113210 8800, www.epilepsy.org.uk. Helpline 0808 800 5050 (freephone) or www.helpline@epilepsy.org.uk
• DVLA, 03007906806, www.gov.uk/contact-the-dvla

As described above, if you have any further seizures, you should attend your local emergency department.

If you are concerned or worried about your health but it is not an emergency you can seek advice through 111 or contact the epilepsy nurses via email: uclh.epilepsy@nhs.net.

If you have any questions about your appointment, you can contact the patient booking team on: 0203 448 4777

Switchboard: 0845 155 5000

Website: www.uclh.nhs.uk