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Q J Med 2003; 96: 87-89
© 2003 Association of Physicians

Editorial

Epilepsy: time for review

P.E.M. Smith1 and J.P. Leach2

1 The Epilepsy Unit, Department of Neurology, University Hospital of Wales, Cardiff e-mail: SmithPE@cardiff.ac.uk 2 Department of Neurology, Institute of Neurological Sciences, Southern General Hospital, Glasgow

The first 10% of the full text of this article appears below.

Review of epilepsy out-patients is often inadequate. Time constraints encourage a largely reactive approach to ‘follow-ups’, with little questioning of existing diagnoses or exploration of the patient's agenda, and undue emphasis on counting seizures, adjusting medication, and restating lifestyle and driving restrictions. Compared to new cases, follow-ups in secondary care are more likely to be delegated to less experienced team members: seeing a different doctor at each visit is dispiriting to both parties.

Yet patients with epilepsy certainly require detailed and long-term follow up, not least because the diagnosis is too often incorrect, particularly in non-specialist hands.1 Epilepsy is diagnosed predominantly on clinical grounds, and where there is doubt, it may be necessary to retake the history (with witness . . . [Full Text of this Article]

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