Children and Young Peoples Epilepsy Service
Epilepsy simply means you have the susceptibility to have seizures and is only diagnosed after you have had more than one unprovoked seizure episode.
What are epileptic seizures?
Electrical activity is happening in our brain all the time as networks of tiny brain cells send messages to each other. These messages control all our thoughts, movements, senses and body functions. A seizure happens when there is a sudden, intense burst of electrical activity in the brain, which causes the messages between cells to get mixed up. The result is an epileptic seizure (Epilepsy Action).
More on what we do
Our epilepsy service sees children and young people that have experienced seizures or episodes that are suspected to be seizures.
You can be referred by your GP, the emergency department or another paediatrician (children's doctor). We will make an appointment to see you face-to-face or by video. We will listen to the story of the episode.
It is useful to bring along someone who has witnessed the episode or has written an account of it because you might not remember what happened. We find it extremely helpful if a parent/carer can video a typical episode because sometimes it is hard to describe what you see.
We will refer you for further tests if we feel they are necessary. These could include a brain scan or an electroencephalogram (EEG). This is a test to find problems associated with electrical activity of the brain.
If we diagnose you with epilepsy, we will continue to see you in clinic and support you and your family. Sometimes young people require medications to control their epilepsy. We will prescribe these for you. The epilepsy nurse is able to support your school or clubs if they have any concerns about your condition.
We work closely with the paediatric (children's) neurosciences centre in Bristol.
There are a range of treatments for epilepsy, including:
Anti-epileptic medications: This is the most common form of treatment. They come in many forms; tablets, liquids or granules, some are taken once daily others are twice a day. The medications reduce the likelihood of you having a seizure. You can discuss medication choices with us in clinic. Find out more here
About 49 per cent of young people will find the first antiepileptic medication effective. Another 21 per cent might require a second medication. Approximately 30 per cent of people with epilepsy will be difficult to treat with medication. For these young people there are other treatment options available.
Ketogenic diet: This is a diet which needs specialist supervision and guidance from our ketogenic dieticians. The ketogenic diet changes the chemical pathways and energy source to the brain. Regular blood monitoring is needed. This diet shouldn’t be started without specialist guidance. You can find out more information by discussing with us in clinic or by looking at:
Epilepsy surgical service and tertiary neurology input: This is a specialist service provided by Bristol Children’s Hospital. Surgery is considered only if medication is not working. If this is a treatment option for you, we will arrange for you to see a paediatric neurologist from Bristol Children’s Hospital in a joint consultation with your Exeter epilepsy specialist doctor and nurse, either by video or face-to-face.
Surgical treatments include:
Vagus nerve stimulation: This is where a device is surgically implanted into the chest wall, a bit like a pace maker. It has two wires that are attached around the vagus nerve. The battery device is programmed to deliver a small electrical current at regular intervals. This current travels up the vagus nerve and into the brain. This device is implanted in Bristol but can be managed locally by our epilepsy nurse. More information and a video can be viewed on this site https://vnstherapy.co.uk/for-children
Resective surgery: in some cases, epilepsy can be caused by an abnormality that can be seen on a MRI scan. It is sometimes possible to have resective surgery to remove the small area of tissue that is causing the seizures. Young people are referred to Bristol for assessment. This can take many months to make sure that this is the right course of treatment.
Psychological support: being diagnosed with a condition such as epilepsy can have an impact on the way you feel about yourself and your future. It can cause you to feel low or have increased anxiety. We can refer your child to a clinical psychologist if they are feeling like this. The psychologist will listen to their concerns and give them coping strategies for managing their feelings.
- Dr Helen Brewer Consultant Paediatrician
- Dr Rachel Howells Consultant Paediatrician and Lead of the Epilepsy service
- Dr Richard Tomlinson Consultant Paediatrician
- Dr Eleanor Thomas Consultant Paediatrician
- Penny Smith Children and Young people’s Epilepsy Nurse Specialist
Where to find us
RD&E Wonford, Barrack Rd, Exeter EX2 5DW
Dr Rachel Howells: Bramble Children’s Unit Template H, Level 1, Wonford Hospital.
Penny Smith, Epilepsy Nurse Specialist: Rm NE51, Neonatal Consultants Suite, Centre for Women’s Health, Wonford Hospital.
If you want to get in touch with the department, please contact:
Dr Rachel Howells Consultant Paediatrician and Lead of the Epilepsy /Neurology service 01392 402668
Dr Richard Tomlinson Consultant Paediatrician: 01392 403159
Dr Eleanor Thomas Consultant Paediatrician: 01392 403128
Dr Helen Brewer Consultant Paediatrician: 01392 403159
Penny Smith Children and Young people’s Epilepsy Nurse Specialist:
Telephone: 01392 406547 / 07554113801
If your child requires an occupational therapy assessment, speech and language therapy assessment, physiotherapy or community children’s nurse, requests should go through the contacts below:
Children and family health Devon
Telephone: 0330 245 321
The Epilepsy Nurse can visit schools, colleges and nurseries to provide help and support and in certain circumstance conduct home visits.
Most clinics are held in paediatric outpatients in area J of the RD&E. If your child attends a specialist school, they might be able to be seen in clinic at the school, rather than in the hospital. Please discuss this with your consultant or the epilepsy nurse.
The epilepsy nurse is here to support you and your family. Please contact her on the numbers listed above. Her work hours are 8am to 4pm, Monday to Friday.
If you feel you would like to blog or chat to someone else the charities Epilepsy action, Epilepsy Society and Young Epilepsy all have helpline numbers which you can contact. You can find these on their websites at the addresses above.