Clinical standards applied for an audit of paediatric epilepsy care
| Standard | |
|---|---|
| Correspondence | |
| Opening correspondence should contain | |
| 1 | Seizure description or classification |
| 2 | Seizure frequency at presentation/referral |
| Subsequent correspondence should record | |
| 3 | Response to drug changes |
| 4 | Advice to parents about possible drug side effects |
| 5 | Yearly reference to development or school progress |
| 6 | Letters should be typed within one week of review |
| Prescribing practice | |
| 7 | First line drug should be either carbamazepine or sodium valproate (except in infantile spasms and true petit mal) |
| 8 | Before considering a first line drug to have failed |
| Sodium valproate should be prescribed to a dosage of 30 mg/kg unless side effects prevented this | |
| Carbamazepine should be prescribed to a dosage of 20 mg/kg unless side effects prevented this, and a therapeutic drug level established | |
| Drug level monitoring | |
| 9 | Serum concentrations of sodium valproate should not be performed except to establish compliance |
| Neuroimaging | |
| 10 | Neuroimaging (CT or MRI) should be performed in partial seizures (except benign epileptic syndromes) |
| Neurophysiology requests | |
| EEG requests should contain | |
| 11 | The child’s age |
| 12 | Current medication |
| 13 | Seizure description or classification |
| Parent satisfaction | |
| 14 | Parents should be satisfied with staff courtesy, communication and clinic visits |