How to refer
Referrals by paediatricians or paediatric neurologists should be
made using the Orion portal:
Make a referral | ORION.
The team are happy to receive letters and notes alongside this
Orion referral, but new cases must be added to this system. The
Orion system will automatically update referrers with progress
through the system - we suggest the lead referring consultant and
child's lead local epilepsy specialist nurse are both entered
during referral.
Referral queries can be directed to the CESS coordinator Darren
Shepherd (Darren.Shepherd@uhbw.nhs.uk).
We are happy to accept referrals for children aged under
18-years for pre-surgical evaluation. Children with any of the
following crieria should be referred:
- All children under the age of 24months with suspected focal
seizure onset with or without identifiable lesion on brain MRI
including those with catastrophic onset epilepsy and developmental
regression. (All children under the age of 24 months should have a
paediatric neurologist involved in their care).
- All children of any age with seizures and unilateral lesions on
MRI, i.e. cortical malformation, developmental tumour, acquired
brain injury, hippocampal sclerosis.
- Certain aetiologies and constellations require special
consideration including Sturge Weber syndrome, unilateral
structural brain lesions (i.e. cortical dysplasia or developmental
tumours) associated with developmental regression +/- continued
seizures, Rasmussen syndrome, hypothalamic hamartoma
- All children of any age with medication resistant seizures
suggestive of focal onset and no identifiable lesion on MRI, that
have failed treatment with two or more anti-seizure
medications
- Children of any age with Tuberous Sclerosis with seizures
resistant to two anti-seizure medications should be evaluated to
see if seizures arise from resectable tubers located in one
hemisphere.
- Children who have 'drop attacks' as part of a more complex
epilepsy, with or without structural brain abnormalities, may also
be suitable for corpus callosotomy.
- Children with epilepsy resistant to medications who may benefit
from a vagal nerve stimulator, who do not otherwise meet the other
criteria.