Adult Epilepsy service
Welcome to the Epilepsy Service. The team consists of four Consultant Neurologists who specialise in Epilepsy and three Epilepsy Nurse Specialists.
We also have a learning disability trained Consultant Nurse in Epilepsy and Epilepsy Specialist Nurse employed by Nottinghamshire Healthcare Foundation Trust.
We take a holistic approach to patients' neurological problems. Our focus is on better seizure control and improved quality of life. We involve patients, carers and families in treatment decisions.
We provide weekly epilepsy clinics for patients with:
- First seizure
- Young people transferring from paediatric care (transition)
- Vagus Nerve Stimulator (VNS)
- Epilepsy and intellectual disability
- Joint antenatal (pregnancy) and epilepsy clinic
- Non-Epileptic Attack Disorder (NEAD)
You may be asked to have some tests. The tests alone won’t determine whether or not you have epilepsy but they will help the neurologist make a diagnosis and decisions about your treatment.
Magnetic resonance imaging (MRI)
What is epilepsy?
Epilepsy means being prone to epileptic seizures. Some seizures are triggered by a one-off occurrence (e.g. seizure immediately after a blow to the head). These are considered to be provoked and do not count as epilepsy. Epilepsy is normally diagnosed after two or more seizures have occurred.
Epileptic seizures are a sudden disturbance of brain activity due to abnormal patterns of intense brain cell activity. The type and pattern of abnormal brain activity will determine the type of seizure. The two main groups of seizure are the generalized type and the focal type. In the generalized type the abnormal electrical activity starts in both halves of the brain simultaneously. In the focal type the seizures start in a small region of the brain, before sometimes spreading elsewhere. The causes and treatments of the two main types tend to differ.
What causes epilepsy?
Epilepsy is divided into two main types. Firstly, the symptomatic epilepsies in which there is a definite cause which creates damage within brain tissue (e.g. brain tumour, head injury, birth trauma, infections). The second group is called idiopathic epilepsy. In these cases there is no obvious damage to the brain and it is often assumed that one of several genes controlling the excitability of nerve cells is at fault. At present it is not usually possible to test for these genetic differences. Seizure control is usually easier in the idiopathic epilepsies.
The causes of epilepsy vary very much with age. In infancy the commoner causes include malformations of the brain, infections, birth trauma, and genetic illnesses, of which epilepsy is only one part. Idiopathic epilepsy commonly starts in school age and teenage years. In adulthood causes such as trauma, stroke, infection and tumour become more common.
I’ve got epilepsy, can I drive?
It is a legal requirement to inform the DVLA that you have had an epileptic seizure. The DVLA will decide whether you are allowed to drive after receiving the medical facts from the neurologist. The decision-making is now more lenient, more complex and more individualized than it used to be. The answer depends on the exact nature and timing of the seizures. Your neurologist will be able to give you more advice on your particular case. Further information is also available on the DVLA and Epilepsy Action websites.
Can I claim any financial benefits?
If you have a diagnosis of epilepsy you may be entitled to receive certain benefits. These may include:
- Disability Living Allowance (for people under 65)
- Personal Independence Payment
- Changes from Disability Living Allowance to Personal Independence Payment
- Attendance Allowance (for people age 65 and over)
For more information about entitlements that may be available for people with epilepsy in the UK visit Epilepsy Action's website.
Can I get free prescriptions?
If you have epilepsy you are entitled to free prescriptions, this includes both epilepsy medication and other prescription medication. To get free prescriptions you need to ask your doctor for an application form FP92A. You fill in parts 1 and 2 and then your doctor signs to confirm that the information you have given is correct. They will then send for an exemption certificate for you.
For more information visit Epilepsy Action's website.
Can I get free travel?
You can apply to your local council for a free bus pass if you have had a seizure involving a loss of awareness in the past 12 months.
Can I work?
Yes. By law employers cannot refuse you a job because you have epilepsy unless they have a good reason for doing so. There are certain jobs that you are legally not allowed to do if you have a history of epilepsy. There are schemes available to help you gain employment such as job seekers and disability employment advisors.
Are there any leisure activities I am not allowed to do?
Most people with epilepsy live full and active lives and take part in the leisure activities that they want to do. How epilepsy affects safety depends on you and your epilepsy. People who have seizures that are controlled with medication may not need the same safety measures as those who still have seizures.
For more information visit Epilepsy Action's website.
I've run out of pills, what should I do?
Antiepileptic drugs must be taken as prescribed. Missing one or more doses can lead to 'breakthrough seizures', and in some cases even prolonged or life threatening seizures (called status epilepticus) that require hospital admission. Be careful not to let your prescription run out.
If you realise that you have run out of antiepileptic drugs contact your GP surgery straight away. If it is a weekend or bank holiday contact the out of hours GP service. Alternatively, you can attend the local Emergency Department, explain the situation and ask for a short supply of your epilepsy tablets.
I've been told that I cannot take anti-depressants. Is this true?
There is no absolute rule about antidepressants in someone with epilepsy. Most modern antidepressants have no more chance of upsetting seizures than antiepileptic drugs themselves. These include common drugs like Citalopram, Venlafaxine and Sertraline. If the neurologist who treats your seizures advises an antidepressant, they will be fully aware of choosing something that should not upset your seizures.
Unfortunately, in the past certain types of antidepressants did occasionally upset seizures. This led to a widespread fear of using antidepressants in epilepsy patients by doctors and pharmacists. Even now, some drug textbooks say antidepressants should not be used in epilepsy, but this is outdated information. Many epilepsy patients develop depression and current guidance is to treat this appropriately, including with antidepressants.
Can flashing light affect my epilepsy?
Flashing light rarely triggers seizures. Only five per cent of people with epilepsy have so called photosensitive epilepsy. Strobe light can make people feel unwell, but this does not mean it is epilepsy.
Photosensitive epilepsy is more common in children and young people and is very unlikely to start above the age of 20.
If you have photosensitive epilepsy, you need to avoid looking into flashing or flickering light. Contrasted dark and light patterns can also trigger seizures. Tiredness and stress can make it worse.
For detailed information about the triggers and what you need to avoid, visit Epilepsy Action.
Epilepsy is much more prevalent in people with learning disabilities than it is in the general population. It is often relatively severe and is the most commonly associated medical condition.
Approximately a third of people with severe learning disability and more than half of those with profound disabilities have epilepsy. With specialist intervention the epilepsy may be just as responsive to modern methods of epilepsy management as in the general population with significant improvements in seizure control possible.
The service has two learning disability trained epilepsy nurses and provides a county-wide integrated learning disability and neurology service to children who are transferring in to adult services and to adults with epilepsy and their carers. Better access to health care, careful assessment and adopting a holistic approach can improve health outcomes and quality of life.
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