Referring a patient to the Children's Epilepsy Surgery Service (CESS)

We accept referrals from consultant paediatricians and from consultant paediatric neurologists. We are unable to accept direct referrals from parents or from GPs.

Please note that requests for MDT discussion of patients considered for VNS treatment should be made by their regional paediatric neurologist, using our CESS referrals proforma.

In order to make the process of the pre-surgical evaluation efficient and reduce waiting times, we require sufficient information for discussion at our CESS referrals MDT meeting (attended by consultant neurologist, clinical neurophysiologist, neuroradiologist and neurosurgeon).

We therefore ask ALL referrals to be made using our CESS referrals pro-forma: CESS Referral Proforma

We cannot process any referral proformas without EEG reports and brain MR images. The EEG and Brain MRI report needs to be included with the referral proforma and the MR images need to be sent electronically via IEP. Once we have received this information, we are then able to discuss the case in our CESS referrals MDT meeting.

Following the CESS MDT meeting we will send a letter to the referrer copied to the family and GP with the conclusion (acceptance or rejection for the pre-surgical evaluation).

• All children <24months of age with suspected focal seizure onset with or without identifiable lesion on brain MRI including those with catastrophic onset epilepsy and developmental regression. (All children <24 months should have a paediatric neurologist involved in their care).
• All children of any age with seizures and unilateral lesions on MRI, i.e. cortical malformation, developmental tumour, acquired brain injury, hippocampal sclerosis.
• Certain aetiologies and constellations require special consideration including Sturge Weber syndrome, unilateral structural brain lesions (i.e. cortical dysplasia or developmental tumours) associated with developmental regression +/- continued seizures, Rasmussen syndrome, hypothalamic hamartoma
• All children of any age with medication resistant seizures suggestive of focal onset and no identifiable lesion on MRI, that have failed treatment with 2 or more anti-seizure medications
• Children of any age with Tuberous Sclerosis with seizures resistant to two AEDs should be evaluated to see if seizures arise from resectable tubers located in one hemisphere.
• Children who have ‘drop attacks’ as part of a more complex epilepsy, with or without structural brain abnormalities, may also be suitable for corpus callosotomy.

All completed proformas including the reports as highlighted above needs to be sent to the CESS Coordinator via secure Email: gos-tr.neuro-referrals@nhs.net - Secure email address nhs.net to nhs.net

If you wish to write to us, please use the address below:

CESS Coordinator
Epilepsy Unit
Level 10, Main Nurses Building
Great Ormond Street Hospital
Great Ormond Street
London
WC1N 3JH

Tel: 020 7405 9200 Ext: 5594/4411

All general feedback and suggestions can be directed to:

CESS Coordinator

Telephone number: 020 7405 9200 ext. 5594/4411