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Guideline review
NICE guideline review: Epilepsies in children, young people and adults NG217
  1. Katherine Elizabeth Anne Jones1,
  2. Rachel Howells1,
  3. Andrew A Mallick2,
  4. Siba Prosad Paul3,
  5. Indranil Dey4
  1. 1 Department of Paediatrics, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
  2. 2 Department of Paediatric Neurology, Bristol Royal Hospital for Children, Bristol, UK
  3. 3 Paediatrics, Yeovil District Hospital, Yeovil, UK
  4. 4 Department of Paediatrics, Torbay and South Devon NHS Foundation Trust, Torquay, UK
  1. Correspondence to Dr Katherine Elizabeth Anne Jones, Department of Paediatrics, Royal Devon University Healthcare NHS Foundation Trust, Exeter, EX2 5DW, UK; katherinejones3{at}nhs.net

https://doi.org/10.1136/archdischild-2022-324427

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    Background

    Epilepsy is the most common significant long-term neurological condition of childhood. The prevalence in children in the UK is approximately 4 per 1000 children. It affects 1 in 220 children and young people in the UK with on average two children with epilepsy in every primary school and nine in every secondary school.1 The National Institute for Health and Care Excellence (NICE) defines epilepsy as a ‘condition in which a person is prone to recurrent epileptic seizures’ and epileptic seizure as a ‘transient occurrence of signs and or symptoms as the result of a primary change to the electrical activity (abnormally excessive or synchronous) within the brain’. The International League against Epilepsy is more specific, defining epilepsy as a disease of the brain defined by at least two unprovoked seizures occurring more than 24 hours apart, one unprovoked seizure and a high probability of further seizures or a diagnosis of an epilepsy syndrome.2

    Information about the current guideline

    In April 2022, NICE published updated guidelines for the diagnosis and management of epilepsies in children, young people and adults (NG217), aiming to improve diagnosis and treatment and reduce the risks for people with epilepsy. The recommendations reflect updated evidence about the medical management of different seizure types as well as more detailed guidance on referral, investigation, diagnosis and liaison with tertiary services. It replaces CG137, published in January 2012.

    It should be used in conjunction with NICE guidance on suspected neurological conditions (NG144) and other NICE guidance on specific medication (cannabidiol, clobazam and fenfluramine) and treatments (vagal nerve stimulation and MRI-guided laser therapy) (see box 1).

    Box 1

    Resources

    • Epilepsies in children, young people and adults: https://www.nice.org.uk/guidance/ng217.

    • Cannabis-based medicinal products: https://www.nice.org.uk/guidance/ng144.

    • Suspected neurological conditions, recognition and referral: https://www.nice.org.uk/guidance/ng127.

    • Cannabidiol and clobazam for treating seizures associated with Dravet: https://www.nice.org.uk/guidance/ta614.

    • Cannabidiol and clobazam for …

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    Footnotes

    • Contributors KEAJ reviewed current and past National Institute for Health and Care Excellence guidance and wrote the final manuscript. RH, AAM and ID provided their expert opinion and reviewed and edited the manuscript. SPP initially suggested this review and offered guidance on its structure. All authors approved the uploaded draft.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.