Telemetry and complex epilepsy admission criteria

This is a list of patient diagnoses which are admitted to Great Ormond Street Hospital (GOSH) by our Telemetry and Complex Epilepsy team, the timeframe in which they should be treated, and their estimated length of stay (LoS).

Health professionals are reminded that this information is for guidance only.

Telemetry

Children with the following diagnoses should be referred to GOSH via the non-emergency pathway.

Diagnosis Estimated Length of Stay (LoS)
Characterisation 1-4 nights
Characterisation of sleep for ESES (Electrical status epilepticus during sleep)/CSWS (Continuous spike and wave discharges during sleep) 1 night
Invasive monitoring 12 days
Pre-surgical evaluation with AED (antiepileptic drug) reduction 4 nights
Pre-surgical evaluation + SPECT (single photon emission computed tomography) scan 4 nights
Pre-surgical evaluation 2-4 nights
VNS (Vagus Nerve Stimulation) implant 1-2 nights

Complex epilepsy

Urgent admissions/reviews

Children with the following diagnoses should be discussed with GOSH neurology on-call team urgently with a completed clinical query form

Diagnosis Estimated LoS
Infantile spasms babies will be admitted for next available EEG (electroencephalogram) slot Day case on the Rapid Aassessment Neurology Unit (RANU)
If epilepsy consultant determines need for acute review in RANU, details entered onto RANU robot and discussed with RANU nurses eg for EEG, bloods, urine, review for new onset myolonic epilepsy, suspected non-convulsive seizure (NCS), new onset epilepsy in children <2yrs of age, catastrophic epilepsy, Sturge-Weber, epileptic encephalopathies Day case on RANU
If known patient of epilepsy consultant, accept clinically appropriate. If needs admission in 1-3 days, epilepsy consultant discusses with acute attending consultant who accepts to acute ward waiting list 1-3 weeks
Seizure characterisation - urgent eg NCS, ESES (Electrical status epilepticus during sleep) 1-4 days

Elective admissions

Children with the following diagnoses should be referred to GOSH via the non-emergency pathway.

Diagnosis Estimated LoS
Planned RANU review with EEG/sleep EEG/prolonged EEG (elective not acute) Day case on RANU

Reviewed by: Dr Suresh Pujar, Consultant Paediatric Neurologist. October 2022