Epilepsy Companion

IMPORTANT: This app is intended for use by qualified healthcare professionals only. Always seek the advice of a qualified clinician before making any medical or prescribing decisions. Epilepsy Companion is a comprehensive evidence-based reference for the diagnosis and management of epilepsy. Built for neurologists, epileptologists, general physicians, emergency doctors, and allied health professionals. SEIZURE CLASSIFICATION - ILAE 2017 three-level classification framework - Focal seizures: aware, impaired awareness, focal to bilateral tonic-clonic - Localisation table: seizure features mapped to brain regions - Generalised seizures: GTCS, absence, myoclonic, tonic, atonic, epileptic spasms - Terminology updates EPILEPSY SYNDROMES - Childhood: SeLECTS, childhood absence epilepsy, Panayiotopoulos, Dravet syndrome - Juvenile: JME triad and lifetime treatment, JAE, epilepsy with GTCS alone - Adult onset: mesial temporal lobe epilepsy, frontal lobe epilepsy, late onset epilepsy - Encephalopathies: West syndrome, Lennox-Gastaut, FIRES FIRST SEIZURE ASSESSMENT - 7-step assessment protocol: was it a seizure, provoked vs unprovoked, investigations - Provoked vs unprovoked table with AED decision guidance - High-risk features favouring AED treatment after first seizure - When epilepsy is diagnosed vs single unprovoked seizure AED DRUG REFERENCE - AED selection matrix by seizure type per NICE NG217 - Focal AEDs: carbamazepine, oxcarbazepine, lacosamide, eslicarbazepine, zonisamide - Generalised AEDs: sodium valproate, ethosuximide, perampanel, rufinamide - Broad spectrum Drugs - Monitoring table - Which AEDs to AVOID STATUS EPILEPTICUS - 4-phase colour-coded protocol: 0-5 min, 5-20 min, 20-40 min, over 40 min - Phase 2: lorazepam 0.1mg/kg IV or buccal midazolam 10mg - Phase 3: levetiracetam 60mg/kg IV (ESETT trial), sodium valproate 40mg/kg IV, fosphenytoin - Phase 4: propofol, midazolam, thiopentone infusion with EEG monitoring - Refractory SE: ketamine, ketogenic diet, immunotherapy for autoimmune encephalitis - Non-convulsive SE WOMEN AND EPILEPSY - MHRA 2024 valproate restrictions and Pregnancy Prevention Programme - Teratogenicity - Valproate PPP 6-step checklist - Lamotrigine level changes in pregnancy - Contraception table: enzyme inducers vs safe AEDs - Folic acid 5mg for all women with epilepsy on AEDs - Breastfeeding guidance by AED DRIVING AND DVLA - Group 1 car licence: 6 visual DVLA rule cards with periods clearly stated - First seizure, established epilepsy, sleep-only seizure rule, AED withdrawal - Group 2 HGV and bus: 10-year seizure-free rule, effectively permanent bar on AEDs - Special situations SURGICAL EVALUATION - ILAE 2010 drug-resistant epilepsy definition - 6-step pre-surgical evaluation protocol - 7 surgical options: temporal and extratemporal resection, corpus callosotomy - VNS, RNS, ANT-DBS (SANTE trial), LITT laser ablation - Outcome data: 60-80 percent seizure freedom after temporal lobectomy DRUG INTERACTIONS - Enzyme inducers: 9 critical interactions including OCP failure, DOAC failure, chemotherapy - Enzyme inhibitors - AED abbreviation reference key SUDEP - Definition, mechanism, and postictal EEG suppression - Risk factors - 9-step prevention protocol - NICE NG217 mandate to counsel all patients - How to discuss SUDEP with patients and families - Resources: SUDEP Action, Epilepsy Society SOURCES AND REFERENCES 25 plus tappable references including NICE NG217, SIGN 143, ILAE 2017 classification, MHRA 2024 valproate guidance, ESETT trial, CONVULSE trial, RAMPART trial, EURAP registry, MONEAD study, SANTE trial, MRC MESS trial, Wiebe temporal lobe surgery RCT, DVLA 2024, SUDEP Action and BNF epilepsy prescribing. DISCLAIMER This app is intended for use by qualified healthcare professionals only as a clinical decision-support and educational reference tool. It does not replace individual clinical assessment, local epilepsy protocols or official prescribing information.