Summary of Case
40 year-old female with uncontrolled epilepsy causing life-threatening tonic-clonic seizures.
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Average of two tonic-clonic seizures per month. These are life-threatening due to post-ictal apnoea.
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Approximately 10-20 absences every day. Many more than this can occur on stressful days.
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'Sub-clinical' seizures happening all the time.
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Buccal Midazolam rescue medication for non-convulsive status epilepticus. This impact of the medication is currently reducing.
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Memory difficulties.
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Continuing Healthcare package in place since 2009.
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Nearly twenty different medications have been tried to gain control of the epilepsy. Nothing to date has had an impact on the life-threatening seizures.
Evidence provided by multiple GPs, one Epilepsy Specialist Nurse and four neurological consultants - all in support of maintaining the package due to the medical needs of the life-threatening seizures.
Decision Support Tool in 2009 identified:
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Priority for Altered States of Consciousness
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Severe for Cognition
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Severe for Medications
Reviews carried out in August 2010, July 2015 and April 2017. Care package remained unchanged.
