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

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).

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 …