Seizures/epilepsy

ADULT

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    Seizures/epilepsy

    • Status epilepticus/epilepsy with concerning features:
      • first seizure
      • focal deficit post-ictally
      • seizure associated with recent trauma
      • persistent severe headache > 1 hour post-ictally
      • seizure with fever

    • Refer to HealthPathways or local guidelines
    • Ensure compliance, consider drug levels if non-compliance is suspected
    • Optimise current drug therapy/consider increasing dose if already on medication
    • Exclude drug interactions e.g. concurrent cytochrome inducers, binding agents
    • Reconsider diagnosis if no response to medication
    • Treat any inter-current infections and co-morbidities
    • Address any lifestyle issues e.g. adequate sleep, stress, alcohol, recreational drugs
    • Adequate chronic disease/lifestyle (SNAP) management is a requirement for most surgical procedures
Minimum Referral Criteria
Category 1
(appointment within 30 calendar days)
  • New diagnosis of epilepsy (confirmed or highly likely) without a review by neurologist
  • First epileptic seizure (as convulsive syncope is a common mimic, may be seen by general medicine prior to neurology, depending on local pathways)
  • Frequent epileptic seizure activity without current use of antiseizure medications
  • Documented increased frequency of Generalised tonic-clonic or bilateral tonic clonic seizures in patient with good adherence to medical treatment
  • Pregnancy in a patient with known epilepsy
Category 2
(appointment within 90 calendar days)
  • Poorly controlled epilepsy (e.g. increased frequency of seizures, change in seizure activity) in patient with good adherence to medical treatment. (This may be categorised as Cat 1 depending on severity)
  • Psychogenic non-epileptic seizures (PNES) /Suspected dissociative attacks* seeking clarification of diagnosis

*Suspected dissociative seizures should be triaged according to the social and medical impact of their epileptic-seizure counterparts rather than based on the (suspected) cause
Category 3
(appointment within 365 calendar days)

  • Chronic epilepsy without any concerning features.  
  • Epilepsy advice and management plan including driving recommendations and decreasing anti-epileptic medication

Concerning features include:

  • persistent focal deficit post-ictally
  • seizure associated with recent trauma
  • persistent severe headache > 1 hour post-ictally
  • seizure with fever

Please insert the below information and minimum referral criteria into referral

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

  • History of seizures
  • Medication history, including non-prescription medications, herbs and supplements
  • Management history of epilepsy (including previous medication, dosage, efficacy, side effects)

3. Additional referral information Useful for processing the referral

  • ELFT, FBC
  • EEG results
  • Neuroimaging results
  • Family history
  • Drug and alcohol history
  • Sleep studies
  • HIV syphilis

4. Request

  • Patient's Demographic Details

    • Full name (including aliases)
    • Date of birth
    • Residential and postal address
    • Telephone contact number/s – home, mobile and alternative
    • Medicare number (where eligible)
    • Name of the parent or caregiver (if appropriate)
    • Preferred language and interpreter requirements
    • Identifies as Aboriginal and/or Torres Strait Islander

    Referring Practitioner Details

    • Full name
    • Full address
    • Contact details – telephone, fax, email
    • Provider number
    • Date of referral
    • Signature

    Relevant clinical information about the condition

    • Presenting symptoms (evolution and duration)
    • Physical findings
    • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
    • Body mass index (BMI)
    • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
    • Current medications and dosages
    • Drug allergies
    • Alcohol, tobacco and other drugs use

    Reason for request

    • To establish a diagnosis
    • For treatment or intervention
    • For advice and management
    • For specialist to take over management
    • Reassurance for GP/second opinion
    • For a specified test/investigation the GP can't order, or the patient can't afford or access
    • Reassurance for the patient/family
    • For other reason (e.g. rapidly accelerating disease progression)
    • Clinical judgement indicates a referral for specialist review is necessary

    Clinical modifiers

    • Impact on employment
    • Impact on education
    • Impact on home
    • Impact on activities of daily living
    • Impact on ability to care for others
    • Impact on personal frailty or safety
    • Identifies as Aboriginal and/or Torres Strait Islander

    Other relevant information

    • Willingness to have surgery (where surgery is a likely intervention)
    • Choice to be treated as a public or private patient
    • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service.  Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.

    • A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.

    • Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

Last updated: 28 September 2026

© State of Queensland (Queensland Health) 2023

Except as permitted under the Copyright Act 1968, no part of this work may be reproduced, communicated or adapted without permission from Queensland Health. To request permission email ip_officer@health.qld.gov.au1.