Seizures

​​​​​​Emergency

If any of the following are suspected, seek emergency medical advice or refer the patient to the emergency department (via ambulance if necessary)

  • Seizures with acute clinical concerns, as indicated by:
    • Developmental, cognitive, psychiatric regression accompanying new onset, or ongoing epileptic seizures
    • New onset of abnormalities on neurological examination (e.g. increasing head circumference centile, focal weakness, gait disturbance, papilloedema, diplopia)
    • New onset of confusion or altered level of consciousness
    • Significant change in seizure frequency, type or duration for established epilepsy
    • Suspected infantile spasms (West syndrome)
      Note: may be frequent brief episodes of head bobbing (with or without arm extension in an infant
      aged < 1 year)
    • Suspected raised intracranial pressure (e.g. bradycardia, hypertension, severe headache)
    • Status epilepticus (i.e. seizure > 5 minutes in duration) 

When public outpatient services are not routinely provided

  • ​Aged between 6 months and 6 years with uncomplicated febrile convulsion​

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.​​
  • Unstable epilepsy requiring re-evaluation and management, as indicated by any of the following features:
    • Focal epilepsy > 1 per month
    • New developmental regression
    • Severe headaches (particularly on waking)
      with associated nausea and vomiting
    • Uncontrolled seizures or events > 1 per month
  • Suspected epilepsy syndrome

Note:

  1. If urgent assessment is clinically indicated within
    1 week, consider contacting the on-call paediatrician
  2. Child seen in an emergency department following a first seizure will be discharged when stable. Specialist follow-up should be arranged by the child's general practitioner, if required
  3. Child who has been reviewed by a paediatrician in an emergency department with a first seizure may not require category 1
​​Category 2
Recommended to be seen within 90 calendar days.
  • Possible functional neurological disorder (for exclusion of organic cause)
  • Suspected or confirmed epilepsy with normal neurological examination and any of the following features:
    • Focal epilepsy < 1 per month
    • Seizures or events < 1 per month
    • Episodes suggestive of epilepsy​
​Category 3

Recommended to be seen within 365 calendar days.

  • ​​Known epilepsy with stable management for transferring paediatric care and have appropriate interim care arrangements in place​

Information to include within a referral

Required

  • Reason for referral
  • Details of the presenting condition, including symptoms and their duration
  • Provisional diagnosis
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically:
    • Associated problems (e.g. incontinence, cyanosis or injuries during events)
    • ​Presence or absence of concerning features (e.g. headaches, focal seizures, personality changes, polyuria or polydipsia, recent onset of clumsiness or poor coordination, unexplained vomiting)
    • Frequency of events and episodes, witnessed or unwitnessed, postictal response
      and duration
    • Possible triggers (e.g. menstruation, sleep disturbance, substance use)
    • Previous management trialled and outcomes (including past medications)
    • Height and weight
    • Head circumference
    • Neurological examination findings​

If available

  • Any previous electroencephalogram (EEG) results
  • Electrocardiogram (ECG) results
  • Current school educational attainments (e.g. good, average, poor, very poor [>2 years behind])
  • Other neurological or development conditions present
  • Other physical examination findings
  • Any relevant laboratory results or medical imaging reports, urinalysis result​

Important information for referring health professionals

If there is a change to a patient’s condition while waiting for their appointment, referring health professionals may further investigate and manage the situation, or send an updated referral to the outpatient service. Where there are significant concerns about a patient's condition, referring health professionals may check HealthPathways for urgent/same day advice or contact the relevant clinical team.​

Current as at: Monday 23 March 2026
Contact page owner: System Purchasing