NICE guideline (NG) 217 covers the diagnosis and management of epilepsy in children, young people, and adults
NICE has published Epilepsies in children, young people and adults, covering the diagnosis and management of epilepsy in primary and secondary care.
NG217 updates and replaces NICE clinical guideline (CG) 137, and aims to improve diagnosis and treatment for different seizure types and epilepsy syndromes, as well as reducing the risks for people with epilepsy.
The new guideline—intended for healthcare professionals in primary, secondary, and tertiary care, as well as commissioners, providers, voluntary organisations, people with epilepsies, and their families and carers—includes recommendations on:
- the diagnosis and assessment of epilepsy, including referral after a first seizure
- providing information and support
- referral to tertiary specialist services
- principles of treatment, safety, monitoring, and withdrawal
- treating epileptic seizures
- treating childhood-onset epilepsies
- treating status epilepticus, repeated or cluster seizures, and prolonged seizures
- non-pharmacological treatments
- psychological, neurobehavioural, cognitive, and developmental comorbidities in epilepsy
- reducing the risk of epilepsy-related death, including sudden unexpected death in epilepsy
- service provision and transition.
According to research by Epilepsy Research UK, epilepsy is one of the most common neurological conditions in the world, and there are over 600,000 people in the UK with a known diagnosis of epilepsy.
It estimates that there are around 100,000 emergency admissions due to epilepsy occurring each year, and on average 21 epilepsy-related deaths in the UK each week.
Future research and increasing costs
The new NICE guideline estimates that the annual cost of epilepsies to the NHS exceeds its 2004 estimate of £2 billion, in particular because of newer and more expensive antiseizure medications now being prescribed. The guideline states: ‘With an increase in treatment costs likely in coming years, it is essential to ensure that antiseizure medications with proven clinical and cost effectiveness are identified.’
In light of the draft version of this guidance being published, Epilepsy Research UK commented on the importance of NICE guidance for guiding future research in the area: ‘The research recommendations … provide an insight into the key areas of epilepsy where more research is needed. This helps ensure organisations like Epilepsy Research UK are funding research that matters the most to people affected by epilepsy.’
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