High Risk Seizures
Patients with high risk seizures need to be assessed for the following at their initial visit, follow up visits and during life transitions.
1
Assess seizure type, duration, frequency, nocturnal seizures, cluster seizures, status epilepticus, and infantile spasms.
Clinician actions
- Educate patients and families on seizure types and increased risk factors to be aware of.
- Counsel on the importance of seizure supervision (See unsupervised seizure).
2
Assess for treatment-resistant epilepsy, also called refractory, intractable or uncontrolled epilepsy. Treatment resistance is “failure of adequate trials of two tolerated, appropriately chosen and used anti-epileptic drug schedules (whether as monotherapies or in combination) to achieve sustained seizure freedom”.
Clinician actions
- If treatment resistant epilepsy is discovered, consider referral to comprehensive epilepsy services.
- Counsel on the importance of treatment adherence.
3
Identify epilepsy syndromes and etiologies associated with high morbidity and mortality.
Clinician actions
- Consider referral to or consultation with comprehensive epilepsy services.
- If patient is seen by multiple Clinician care providers, develop mechanisms for communication and coordination of care.
Conversation tips
Learn how to discuss high-risk seizures with your patients