Summary of Case

40 year-old female with uncontrolled epilepsy causing life-threatening tonic-clonic seizures.

  • Average of two tonic-clonic seizures per month. These are life-threatening due to post-ictal apnoea.

  • Approximately 10-20 absences every day. Many more than this can occur on stressful days.

  • 'Sub-clinical' seizures happening all the time. 

  • Buccal Midazolam rescue medication for non-convulsive status epilepticus. This impact of the medication is currently reducing.

  • Memory difficulties.

  • Continuing Healthcare package in place since 2009.

  • 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:

  • Priority for Altered States of Consciousness

  • Severe for Cognition

  • Severe for Medications

Reviews carried out in August 2010, July 2015 and April 2017.  Care package remained unchanged. 

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