Epilepsi - NICE

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The epilepsies: the diagnosis andmanagement of the epilepsies inadults and children in primary andsecondary care

KKM: FMJQ 2012 DKL EG: EJ 2013

ICE ? 137

MF.F.GJ.M/137

*C! @K JL L@ HJGKK MK Q L@ CFLJ GJ CDFD JL L *C! LG HJGM

MDFK. AJLLGF K ND GJ 5 QJK JGE HLEJ 2009 F HHDK LG MDFK HJGM

KF AHJD 2007 MKF L@ HJGKKK KJ F *C!'K '@ MDFK EFMD' (2007, MHL

2009). GJ FGJELGF GF JLLGF F NO L OOO.F.GJ.M/JLLGF

T *C! 2012


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C>>=

FLJGMLGF................................................................................................................................. 7

JKGF-FLJ J................................................................................................................... 9

Q HJGJLK GJ EHDEFLLGF ................................................................................................ 10

FGKK............................................................................................................................................... 10

FEFL ......................................................................................................................................... 10

JGDGF GJ JHL KRMJK F GFNMDKN KLLMK HDHLMK....................................................... 10

HD GFKJLGFK GJ OGEF F JDK G @DJF HGLFLD................................................... 11

NO F JJJD ............................................................................................................................... 11

1 #MF ................................................................................................................................. 12

1.1 JFHD G KGF EF............................................................................................................ 12

1.2 CGHF OL@ HDHKQ ....................................................................................................................... 12

1.3 FGJELGF ...................................................................................................................................... 13

1.4 GDDGOF JKL KRMJ................................................................................................................... 16

1.5 FGKK......................................................................................................................................... 17

1.6 FNKLLGFK .................................................................................................................................. 18

1.7 CDKKLGF ................................................................................................................................... 22

1.8 FEFL ................................................................................................................................... 22

1.9 @JEGDGD LJLEFL ............................................................................................................. 23

1.10 JJD GJ GEHDP GJ JJLGJQ HDHKQ ................................................................................... 39

1.11 KQ@GDGD FLJNFLGFK ........................................................................................................... 41

1.12 LGF L ............................................................................................................................... 41

1.13 MK FJN KLEMDLGF (*) .................................................................................................... 42

1.14 JGDGF GJ JHL KRMJK F GFNMDKN KLLMK HDHLMK .............................................. 42

1.15 GEF F JDK OL@ HDHKQ...................................................................................................... 45

1.16 C@DJF, QGMF HGHD F MDLK OL@ DJFF KDLK (K DKG KLGFK 1.15 F 1.17)... 50

1.17 GMF HGHD OL@ HDHKQ (K DKG KLGF 1.15)...................................................................... 52

@ HDHKK: L@ FGKK F EFEFL G L@ HDHKK F

MDLK F @DJF F HJEJQ F KGFJQ J*C! DFD

MDF 137

T *C! 2012. ADD J@LK JKJN. KL EG EJ 2013 2 G 116


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1.18 DJ HGHD OL@ HDHKQ ............................................................................................................ 53

1.19 C@DJF, QGMF HGHD F MDLK JGE D F EFGJLQ L@F JGMHK................................... 54

1.20 NO........................................................................................................................................... 54

2 *GLK GF L@ KGH G L@ MF........................................................................................ 58

3 EHDEFLLGF ....................................................................................................................... 59

4 KJ@ JGEEFLGFK ................................................................................................... 60

4.1 *ODQ FGK KRMJK (GD F FJDK) U EGFGL@JHQ................................................ 60

4.2 !HDHKQ KQFJGEK ........................................................................................................................ 61

4.3 FFLD KHKEK .............................................................................................................................. 61

4.4 JLEFL G GFNMDKN KLLMK HDHLMK (L@L K, FGL MKL JJLGJQ)........................................... 62

4.5 A!K F HJFFQ ...................................................................................................................... 63

5 L@J NJKGFK G L@K MDF ............................................................................................... 65

5.1 MDD MDF ................................................................................................................................... 65

5.2 *C! HL@OQ ................................................................................................................................. 65

5.3 FGJELGF GJ L@ HMD................................................................................................................. 65

6 DL *C! MF........................................................................................................... 66

7 HLF L@ MDF............................................................................................................. 67

AHHFP A: @ #MDF NDGHEFL #JGMH, *LGFD CDFD #MDF CFLJ F *C!

HJGL LE................................................................................................................................ 68

#MDF NDGHEFL #JGMH (2012, HJLD MHL)........................................................................... 68

#MDF NDGHEFL #JGMH (2004) .................................................................................................. 69

#MDF NDGHEFL #JGMH G-GHL PHJLK ................................................................................. 70

*LGFD CDFD #MDF CFLJ ....................................................................................................... 72

!PLJFD HJ JNOJK......................................................................................................................... 73

*C! HJGL LE................................................................................................................................. 73

AHHFP B: @ #MDF NO FD.................................................................................. 74

2012 #MDF (HJLD MHL)............................................................................................................. 74



MDF 137



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2004 #MDF ...................................................................................................................................... 74

AHHFP C: MLDF J DGJL@EK ......................................................................................... 75

AHHFP : JFLD FGKK G HDHKQ F @DJF, QGMF HGHD F MDLK................. 76

AHHFP !: @JEGDGD LJLEFL .................................................................................... 77

AHHFP : JGLGGDK GJ LJLF GFNMDKN KLLMK HDHLMK F MDLK F @DJF (MDLK

HMDK@ F 2004 F @DJF HMDK@ F 2011)..................................................................... 96

JLF GFNMDKN KLLMK HDHLMK F MDLK (HMDK@ F 2004)..................................................... 96

#MDFK GJ LJLF GFNMDKN KLLMK HDHLMK F @DJF (HMDK@ F 2011)............................ 99

*GF-GFNMDKN KLLMK HDHLMK F MDLK F @DJF (2004 MDF) ........................................... 100

AHHFP #: AJNLGFK F DGKKJQ ................................................................................... 102

AKF KRMJ ................................................................................................................................... 102

A@JF ............................................................................................................................................ 103

AMFLN LJLEFL ............................................................................................................................ 103

ALGDGQ ............................................................................................................................................... 103

AFL-HDHL JM (A!) ...................................................................................................................... 103

ALGF KRMJ ....................................................................................................................................... 103

ALL ................................................................................................................................................... 103

BKDF ................................................................................................................................................ 103

BFF HDHKQ OL@ FLJGLEHGJD KHK (B!C) ......................................................................... 104

CJJ .................................................................................................................................................... 104

C@D@GG KF HDHKQ ................................................................................................................ 104

CDFD HJKFLLGF ............................................................................................................................. 104

CDFF ................................................................................................................................................ 104

CGEGJLQ .......................................................................................................................................... 104

CGFGJF ........................................................................................................................................ 105

CGFLFMGMK KH F ON MJF KDGO KDH (C) ...................................................................... 105

CGFNMDKN KLLMK HDHLMK ............................................................................................................... 105



MDF 137



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GK ................................................................................................................................................. 105

JNL KQFJGE .................................................................................................................................. 105

!DLJGJGJE (!C#) ..................................................................................................................... 105

!DLJGFH@DGJE (!!#) .............................................................................................................. 106

!HDHKQ ................................................................................................................................................ 106

!HDHKQ KQFJGE ............................................................................................................................... 106

!HDHL KRMJ ................................................................................................................................... 106

GD KRMJ ........................................................................................................................................ 106

#FJDK KRMJ ............................................................................................................................. 106

#FJDK LGFUDGF (#C) KRMJ .............................................................................................. 107

#FL (OL@ JJF LG HDHKQ) ..................................................................................................... 107

LD H@FGEFGDGQ ............................................................................................................................ 107

GHL@ .............................................................................................................................................. 107

GHL@ FJDK HDHKQ (#!) .................................................................................................. 107

FLGF (KH) ............................................................................................................................... 107

FFLD KHKEK ................................................................................................................................... 108

FLJNFLGF ........................................................................................................................................... 108

MNFD KF HDHKQ ................................................................................................................... 108

MNFD EQGDGF HDHKQ (!) ...................................................................................................... 108

LGF L ...................................................................................................................................... 108

FMUDFJ KQFJGE () ........................................................................................................ 108

L-GFKL @D@GG GHLD HDHKQ (#KLML LQH) ........................................................................ 109

FFGPU#KLML KQFJGE .................................................................................................................. 109

GFGL@JHQ ........................................................................................................................................ 109

QGDGF-KLL HDHKQ (A!) ........................................................................................................ 109

QGDGF KRMJK ............................................................................................................................... 109

*MJGDGD L ............................................................................................................................... 109



MDF 137



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*GF-GFNMDKN KLLMK HDHLMK ........................................................................................................ 110

*GF-HDHL LL KGJJ (*!A) .................................................................................................. 110

DJ HGHD ......................................................................................................................................... 110

FQGLGHGMDGK KQFJGE .................................................................................................................. 110

@JEGFLK ................................................................................................................................. 110

GDQH@JEQ ....................................................................................................................................... 110

GDQL@JHQ .......................................................................................................................................... 111

JGFGKK ............................................................................................................................................. 111

JGNGLGF L@FIMK ........................................................................................................................ 111

MDLQ G D ......................................................................................................................................... 111

JLGJQ KLLMK HDHLMK ................................................................................................................ 111

GFJDQ FJDK KRMJ .......................................................................................................... 111

EHD F GEHDP HJLD HDHL KRMJK ..................................................................................... 112

HDKL (K MK F L@K MDF) .................................................................................................... 112

MF MFPHL (GJ MFPHDF) L@ F HDHKQ (!) ...................................................... 112

QFGH ............................................................................................................................................... 112

JLJQ HDHKQ KHDKL .................................................................................................................... 112

JLJQ KJN ..................................................................................................................................... 112

GF KRMJ ........................................................................................................................................ 113

GFUDGF KRMJ ............................................................................................................................. 113

C@FK LJ HMDLGF........................................................................................................... 114

AGML L@K MDF .................................................................................................................... 115



MDF 137



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I>

@K MF MHLK F JHDK *C! DFD MDF 20. @K MF DKG MHLKF JHDK *C! L@FGDGQ HHJKD 76 (2004) F *C! L@FGDGQ HHJKD 79

(2004).

*O JGEEFLGFK @N F GJ L@ H@JEGDGD LJLEFL G HGHD OL@

HDHKQ, FDMF L@ MK GLGF L (KAGML L@K MDF GJ LDK).

!HDHKQ K GEEGF FMJGDGD KGJJ @JLJK Q JMJJF KRMJK. JFL LQHK

G HDHKQ @N JFL MKK. AMJL KLELK G FF F HJNDF J MDL LG

@N MK FLQF HGHD O@G EQ @N HDHKQ K MDL. !HDHKQ @K FKLEL LG L LOF 362,000 F 415,000 HGHD F !FDF. F LGF, L@J ODD

MJL@J FNMDK, KLEL LG 5U30%, KG EGMFLF LG MH LG FGL@J 124,500 HGHD, O@G

@N F FGK OL@ HDHKQ, ML F O@GE L@ FGKK K FGJJL. FF K

KLEL LG 50 HJ 100,000 HJ QJ F L@ HJNDF G LN HDHKQ F L@ K

KLEL LG 5U10 KK HJ 1000. OG-L@JK G HGHD OL@ LN HDHKQ @N L@J

HDHKQ GFLJGDD KLKLGJDQ OL@ FL-HDHL JMK (A!K). L@J HHJG@K EQ FDM

KMJJQ. HLED EFEFL EHJGNK @DL@ GMLGEK F F DKG @DH LG EFEK GL@J,

GLF LJEFLD, EHLK GF KGD, MLGFD F EHDGQEFL LNLQ. @ HDHKK (*C!

DFD MDF 20) KLL L@L L@ FFMD KLEL GKL G KLDK@ HDHKK OK

S2 DDGF (JL F FJL GKLK).

*OJ F EGJ PHFKN A!K J FGO F HJKJ, F OL@ F FJK F LJLEFL

GKLK DDQ F GEF QJK L K KKFLD LG FKMJ L@L A!K OL@ HJGNF DFD F GKL

LNFKK J FL. @ NF MK LG NDGH @ HDHKK (*C! DFD

MDF 20), *OJ JMK GJ HDHKQ F MDLK (*C! L@FGDGQ HHJKD MF 76) F

*OJ JMK GJ HDHKQ F @DJF (*C! L@FGDGQ HHJKD MF 79) K@GO FG

JF F LNFKK LOF FOJ F GDJ A!K, GJ LOF L@ FOJ JMK (K

EGFGL@JHQ) GJ KRMJ GFLJGD. $GONJ, JFL DJ EMDLFLJ LJD (L@ A*A LJD)

NDMLF FOJ JMK F FODQ FGK HDHKQ (HLF KGE DELLGFK) KMKL L@L

KGME NDHJGL K@GMD L@ JM G @G F FJDK F MFDKKD HDHKK, F

DEGLJF F GD HDHKK. L OK L@JGJ GFKJ FKKJQ LG JNO FO NF

JJF A!K OL@F F MHL G *C! DFD MDF 20 (O@@ OK HMDK@ F 2004).

@ MDF ODD KKME L@L HJKJJK ODD MK JM'K KMEEJQ G HJGML @JLJKLK LG

FGJE KGFK E OL@ FNMD HLFLK.



MDF 137

http://publications.nice.org.uk/the-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-cg137/appendix-g-abbreviations-and-glossary#epilepsyhttp://publications.nice.org.uk/the-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-cg137/appendix-g-abbreviations-and-glossary#ketogenic-diet-2http://publications.nice.org.uk/the-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-and-cg137/about-this-guidelinehttp://publications.nice.org.uk/the-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-cg137/appendix-g-abbreviations-and-glossary#anti-epileptic%20drugs%20(AEDs)http://www.nice.org.uk/guidance/CG20http://www.nice.org.uk/guidance/CG20http://www.nice.org.uk/guidance/TA76http://www.nice.org.uk/guidance/TA79http://publications.nice.org.uk/the-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-cg137/appendix-g-abbreviations-and-glossary#monotherapyhttp://publications.nice.org.uk/the-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-cg137/appendix-g-abbreviations-and-glossary#monotherapyhttp://www.nice.org.uk/guidance/TA79http://www.nice.org.uk/guidance/TA76http://www.nice.org.uk/guidance/CG20http://www.nice.org.uk/guidance/CG20http://publications.nice.org.uk/the-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-cg137/appendix-g-abbreviations-and-glossary#anti-epileptic%20drugs%20(AEDs)http://publications.nice.org.uk/the-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-and-cg137/about-this-guidelinehttp://publications.nice.org.uk/the-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-cg137/appendix-g-abbreviations-and-glossary#ketogenic-diet-2http://publications.nice.org.uk/the-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-cg137/appendix-g-abbreviations-and-glossary#epilepsy


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@K MDF JGEEFK KGE JMK GJ FLGFK GJ O@@ L@Q G FGL @N

EJLF ML@GJKLGF L L@ L G HMDLGF, L@J K GG NF LG KMHHGJL L@L MK.

@J JGEEFLGFK @N F E GJ L@ MK G JMK GMLK L@J DFK FLGFK

('G-DD MK'), L@K JMK J EJ OL@ GGLFGL F L@ JGEEFLGFK.



MDF 137



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"


10/116

K ;>

@ GDDGOF JGEEFLGFK @N F FL K HJGJLK GJ EHDEFLLGF.

Diagnosis

ADD @DJF, QGMF HGHD F MDLK OL@ JFL GFKL KMKHL KRMJ K@GMD KF

MJFLDQ1 Q KHDKL2. @K K LG FKMJ HJK F JDQ FGKK F FLLGF G

L@JHQ K HHJGHJL LG L@J FK. *2004+

Management

$DL@J HJGKKGFDK K@GMD GHL GFKMDLF KLQD L@L FDK L@ @D, QGMF

HJKGF GJ MDL OL@ HDHKQ, F L@J EDQ F/GJ JJK K HHJGHJL, LG HJLHL K

HJLFJK F DD KGFK GML L@J @DL@J, F L MDDQ FLG GMFL L@J J, MDLMJ

F FQ KH FK. *2004+

ADD @DJF, QGMF HGHD F MDLK OL@ HDHKQ K@GMD @N GEHJ@FKN J HDF

L@L K J LOF L@ HJKGF, L@J EDQ F/GJ JJK K HHJGHJL, F HJEJQ

F KGFJQ J HJGNJK. *2004+

@ A! (FL-HDHL JM) LJLEFL KLJLQ K@GMD FNMDK GJF LG L@

KRMJ LQH, HDHKQ KQFJGE, G-ELGF F G-EGJLQ, L@ @D, QGMF HJKGF GJ

MDL'K DKLQD, F L@ HJJFK G L@ HJKGF, L@J EDQ F/GJ JJK K HHJGHJL.

*2004+

Prolonged or repeated seizures andconvulsive status

epilepticus

FDQ HJKJ MD ERGDE GJ JLD RHE3 GJ MK F L@ GEEMFLQ GJ @DJF,

QGMF HGHD F MDLK O@G @N @ HJNGMK HKG G HJGDGF GJ KJD GFNMDKN

KRMJK. * 2012+

AEFKLJ MD ERGDE K JKL-DF LJLEFL F @DJF, QGMF HGHD F MDLK OL@

HJGDGF GJ JHL KRMJK F L@ GEEMFLQ. AEFKLJ JLD RHE3 HJJJ

GJ MD ERGDE K FGL NDD. FLJNFGMK KK K DJQ KLDK@ F

JKMKLLGF DLK J NDD, EFKLJ FLJNFGMK DGJRHE. * 2012+



MDF 137

http://publications.nice.org.uk/the-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-cg137/appendix-g-abbreviations-and-glossary#specialist-as-used-in-this-guidelinehttp://publications.nice.org.uk/sthe-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-cg137/appendix-g-abbreviations-and-glossary#epilepsy-syndromehttp://publications.nice.org.uk/sthe-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-cg137/appendix-g-abbreviations-and-glossary#convulsive-status-epilepticus-2http://publications.nice.org.uk/sthe-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-cg137/appendix-g-abbreviations-and-glossary#convulsive-status-epilepticus-2http://publications.nice.org.uk/sthe-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-cg137/appendix-g-abbreviations-and-glossary#convulsive-status-epilepticus-2http://publications.nice.org.uk/sthe-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-cg137/appendix-g-abbreviations-and-glossary#convulsive-status-epilepticus-2http://publications.nice.org.uk/sthe-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-cg137/appendix-g-abbreviations-and-glossary#epilepsy-syndromehttp://publications.nice.org.uk/the-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-cg137/appendix-g-abbreviations-and-glossary#specialist-as-used-in-this-guideline


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Special considerations for women and girls of childbearing

potential

GEF F JDK OL@ HDHKQ F L@J HJLFJK, K HHJGHJL, EMKL NF MJL

FGJELGF F GMFKDDF GML GFLJHLGF, GFHLGF, HJFFQ, JF GJ @DJF,

JKLF F EFGHMK. *2004+

Review and referral

ADD @DJF, QGMF HGHD F MDLK OL@ HDHKQ K@GMD @N JMDJ KLJMLMJ JNO.

F @DJF F QGMF HGHD, L@K JNO K@GMD JJ GML L DKL QJDQ (ML EQ

LOF 3 F 12 EGFL@K Q JJFEFL) Q KHDKL. F MDLK, L@K JNO K@GMD

JJ GML L DKL QJDQ Q L@J FJDKL GJ KHDKL, HFF GF @GO ODD L@

HDHKQ K GFLJGDD F/GJ L@ HJKF G KH DKLQD KKMK. *2004+

AL L@ JNO, @DJF, QGMF HGHD F MDLK K@GMD @N KK LG: OJLLF F NKMD

FGJELGF; GMFKDDF KJNK; FGJELGF GML NGDMFLJQ GJFKLGFK; HDHKQ

KHDKL FMJKK; LEDQ F HHJGHJL FNKLLGFK; JJJD LG LJLJQ KJNK, FDMF

KMJJQ HHJGHJL. *2004+

KRMJK J FGL GFLJGDD F/GJ L@J K FGKL MFJLFLQ GJ LJLEFL DMJ,

@DJF, QGMF HGHD F MDLK K@GMD JJJ LG LJLJQ KJNK KGGF4 GJ MJL@J

KKKKEFL. *2004+

1 @ #MDF NDGHEFL #JGMH GFKJ L@L 'MJFLDQ' EFL F KF OL@F 2 OK.

2 GJ MDLK, KHDKL K F L@JGM@GML K ED HJLLGFJ OL@ LJFF F

PHJLK F HDHKQ. GJ @DJF F QGMF HGHD, KHDKL K F L@JGM@GML K

HLJF OL@ LJFF F PHJLK F HDHKQ.

3AL L@ LE G HMDLGF (FMJQ 2012), L@K JM FGL @N EJLF ML@GJKLGF GJ

L@K FLGF F/GJ HGHMDLGF (K HHFP ! GJ LDK). FGJE GFKFL K@GMD

GLF F GMEFL F DF OL@ FGJED KLFJK F EJFQ J.

4 @ #MDF NDGHEFL #JGMH GFKJ L@L 'KGGF' EFL F KF OL@F 4 OK.



MDF 137

http://publications.nice.org.uk/sthe-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-cg137/appendix-g-abbreviations-and-glossary#tertiary-servicehttp://publications.nice.org.uk/the-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-and-cg137/appendix-e-pharmacological-treatmenthttp://publications.nice.org.uk/the-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-and-cg137/appendix-e-pharmacological-treatmenthttp://publications.nice.org.uk/sthe-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-cg137/appendix-g-abbreviations-and-glossary#tertiary-service


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1 G?

@ GDDGOF MF K K GF L@ KL NDD NF. @ MDD MDF NK LDK

G L@ EL@GK F L@ NF MK LG NDGH L@ MF.

F L@K MDF, L@ LJE 'MDLK' K MK LG KJ HGHD O@G J 18 QJK F GDJ,

F '@DJF' L@GK O@G J 28 QK LG 11 QJK. 'GMF HGHD' KJK L@GK O@G J

12 LG 17 QJK. 'DJ HGHD' K MK LG KJ HGHD O@G J 65 QJK GJ GDJ U

L@K JF K K GF NF JNO Q L@ #MDF NDGHEFL #JGMH. $GONJ, L

K JGFK L@L L@J K NJD JF (15U19 QJK) L O@@ J K LJFKJJ

LOF @D F MDL @DL@ KJNK Q DGD @DL@J LJMKLK F HJEJQ J

GJFKLGFK.

DK K HHFP # GJ FLGFK G JNLGFK F DGKKJQ G LJEK MK L@JGM@GML

L@K MDF.

1.1 Principle of decision making

1.1.1 $DL@J HJGKKGFDK K@GMD GHL GFKMDLF KLQD L@L FDK L@ @D,

QGMF HJKGF GJ MDL OL@ HDHKQ, F L@J EDQ F/GJ JJK K

HHJGHJL, LG HJLHL K HJLFJK F DD KGFK GML L@J @DL@J,

F L MDDQ FLG GMFL L@J J, MDLMJ F FQ KH FK. *2004+

1.2 Coping with epilepsy

1.2.1 C@DJF, QGMF HGHD F MDLK OL@ HDHKQ F L@J EDK F/GJ

JJK K@GMD EHGOJ LG EF L@J GFLGF K ODD K HGKKD.

*2004+

1.2.2 AMDLK K@GMD JN HHJGHJL FGJELGF F MLGF GML DD KHLK

G HDHKQ. @K EQ KL @N F EFLF L@JGM@ KLJMLMJ KD-

EFEFL HDFK. *2004+

1.2.3 F @DJF F QGMF HGHD, KD-EFEFL G HDHKQ EQ KL

@N L@JGM@ LN @D-FLJ LJFF EGDK F FLJNFLGFK. *2004+



MDF 137

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1.2.4 $DL@J HJGKKGFDK K@GMD @@D@L L@ !PHJL LFLK JGJEE

(OOO.PHJLHLFLK.G.M5) LG @DJF, QGMF HGHD F MDLK OL@ HDHKQ

O@G OK@ LG EF L@J GFLGF EGJ LNDQ. *2004, 2012+

1.3 Information

1.3.1 C@DJF, QGMF HGHD F MDLK OL@ HDHKQ F L@J EDK F/GJ

JJK K@GMD NF, F @N KK LG KGMJK G, FGJELGF GML

(O@J HHJGHJL):

HDHKQ F FJD

FGKK F LJLEFL GHLGFK

ELGF F K LK

KRMJ LQH(K), LJJK F KRMJ GFLJGD

EFEFL F KD-J

JK EFEFL

JKL , KLQ F FMJQ HJNFLGF L @GE F L K@GGD GJ OGJ

HKQ@GDGD KKMK

KGD KMJLQ FLK F KGD KJNK

FKMJF KKMK

MLGF F @DL@J L K@GGD

EHDGQEFL F FHFFL DNF GJ MDLK

EHGJLF G KDGKF HDHKQ L OGJ, JDNFL ( MJL@J FGJELGF GJ

DJLGF K F, NGDMFLJQ GJFKLGFK K@GMD GFLL)

JG KLQ F JNF

HJGFGKK



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KMF L@ F HDHKQ (!)

KLLMK HDHLMK

DKLQD, DKMJ F KGD KKMK (FDMF JJLGFD JMK, DG@GD, KPMD

LNLQ F KDH HJNLGF)

EDQ HDFFF F HJFFQ

NGDMFLJQ GJFKLGFK, KM@ K KMHHGJL JGMHK F @JLD GJFKLGFK, F

@GO LG GFLL L@E. *2004+

1.3.2 @ LE L O@@ L@K FGJELGF K@GMD NF ODD HF GF L@ JLFLQ

G L@ FGKK, F L@ F GJ GFJELGJQ FNKLLGFK. *2004+

1.3.3 FGJELGF K@GMD HJGN F GJELK, DFMK F OQK L@L J KML

LG L@ @D, QGMF HJKGF GJ MDL'K JIMJEFLK. CGFKJLGF K@GMD

NF LG NDGHEFLD , FJ, MDLMJ F KL G D G L@ HJKGF.

*2004+

1.3.4 @DJF, QGMF HGHD F MDLK, F L@J EDK F/GJ JJK, @N FGL

DJQ GMF @@-IMDLQ FGJELGF JGE NGDMFLJQ GJFKLGFK F GL@JKGMJK, @DL@J HJGKKGFDK K@GMD FGJE L@E G JFL KGMJK

(MKF L@ FLJFL, HHJGHJL: K, GJ PEHD, L@ OKL G L@ GFL

!HDHKQ CGMFD G L@ F JDF, OOO.GFLHDHKQGMFD.GJ.M).

*2004+

1.3.5 AIML LE K@GMD KL K F L@ GFKMDLLGF LG HJGN FGJELGF,

O@@ K@GMD JNKL GF KMKIMFL GFKMDLLGFK. *2004+

1.3.6 C@DKLK K@GMD MK LG JEF @DJF, QGMF HGHD F MDLK, F

@DL@J HJGKKGFDK, GML FGJELGF L@L K@GMD KMKK MJF

GFKMDLLGFK. *2004+

1.3.7 !NJQGF HJGNF J GJ LJLEFL GJ @DJF, QGMF HGHD F MDLK

OL@ HDHKQ K@GMD D LG HJGN KKFLD FGJELGF. *2004+



MDF 137

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1.3.8 @ @D, QGMF HJKGF GJ MDL OL@ HDHKQ F L@J EDQ F/GJ JJK K

HHJGHJL K@GMD FGO @GO LG GFLL FE FNMD O@F FGJELGF

K F. @K FE FNMD K@GMD EEJ G L@ @DL@J LE

F JKHGFKD GJ FKMJF L@L L@ FGJELGF FK G L@ @D, QGMF

HJKGF GJ MDL F/GJ L@J EDQ F/GJ JJK J EL. *2004+

1.3.9 @ HGKKDLQ G @NF KRMJK K@GMD KMKK, F FGJELGF GF

HDHKQ K@GMD HJGN GJ KRMJK GMJ, GJ @DJF, QGMF HGHD

F MDLK L @@ JK G NDGHF KRMJK (KM@ K LJ KNJ JF

FMJQ), OL@ DJFF KDLQ, GJ O@G @N KLJGF EDQ @KLGJQ G

HDHKQ. *2004+

1.3.10 C@DJF, QGMF HGHD F MDLK OL@ HDHKQ K@GMD NF HHJGHJL

FGJELGF GJ L@Q E EHGJLFL KGFK (GJ PEHD, JJF

HJFFQ GJ EHDGQEFL). *2004+

$? ?;> > ;;= ($&DE")

1.3.11 FGJELGF GF ! K@GMD FDM F DLJLMJ GF HDHKQ LG K@GO

O@Q HJNFLF KRMJK K EHGJLFL. DGJ FGJELGF GF L@ HJKGF'K

JDLN JK G ! K@GMD HJL G L@ GMFKDDF @DKL GJ @DJF,

QGMF HGHD F MDLK OL@ HDHKQ F L@J EDK F/GJ JJK. *2004+

1.3.12 @ JK G ! F EFEK Q:

GHLEKF KRMJ GFLJGD

F OJ G L@ HGLFLD GFKIMFK G FGLMJFD KRMJK. *2004+

1.3.13 DGJ FGJELGF F KMKKGF LOF L@ @D, QGMF HJKGF GJ MDL

OL@ HDHKQ, L@J EDQ F/GJ JJK (K HHJGHJL) F @DL@J

HJGKKGFDK K@GMD L GMFL G L@ KEDD ML FL JK G !.

*2004+

1.3.14 @J EDK F/GJ JJK @N F L Q !, @DL@J

HJGKKGFDK K@GMD GFLL EDK F/GJ JJK LG GJ L@J GFGDFK,



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FNL L@E LG KMKK L@ L@, F GJ JJJD LG JNEFL GMFKDDF

F ! KMHHGJL JGMH. *2004+

1.4 Following a first seizure

1.4.1 C@DJF, QGMF HGHD F MDLK HJKFLF LG F AFL F !EJFQ

HJLEFL GDDGOF KMKHL KRMJ K@GMD KJF FLDDQ. @K

K@GMD GF Q F MDL GJ HLJ H@QKF OL@ GFOJ JJJD LG

KHDKL6 O@F F HDHL KRMJ K KMKHL GJ L@J K FGKL GML.

*2004+

1.4.2 JGLGGDK K@GMD F HD L@L FKMJ HJGHJ KKKKEFL F L@ EJFQ

KLLF GJ @DJF, QGMF HGHD F MDLK HJKFLF OL@ F HDHL

KRMJ (KMKHL GJ GFJE). *2004+

1.4.3 @ FGJELGF L@L K@GMD GLF JGE L@ MDL F/GJ EDQ GJ JJ

LJ KMKHL KRMJ K GFLF F HHFP . *2004+

1.4.4 @ FGJELGF L@L K@GMD GLF JGE L@ @D GJ QGMF HJKGF F/GJ

HJFL GJ JJ LJ KMKHL KRMJ K GFLF F HHFP . *2004+

1.4.5 L K JGEEF L@L DD MDLK @NF JKL KRMJ K@GMD KF K KGGF

K HGKKD7 Q KHDKL F L@ EFEFL G L@ HDHKK LG FKMJ

HJK F JDQ FGKK F FLLGF G L@JHQ K HHJGHJL LG L@J

FK. *2004+

1.4.6 L K JGEEF L@L DD @DJF F QGMF HGHD O@G @N @ JKL FGF-

JD KRMJ K@GMD KF K KGGF K HGKKD

7

Q KHDKL F L@EFEFL G L@ HDHKK LG FKMJ HJK F JDQ FGKK F

FLLGF G L@JHQ K HHJGHJL LG L@J FK. *2004+

1.4.7 AL L@ FLD KKKKEFL GJ JFL GFKL KRMJ, L@ KHDKL K@GMD @N

KK LG HHJGHJL FNKLLGFK. *2004+

1.4.8 F @D, QGMF HJKGF GJ MDL HJKFLF OL@ F LL, H@QKD

PEFLGF K@GMD JJ GML. @K K@GMD JKK L@J J,



MDF 137

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FMJGDGD F EFLD KLLMK, F K@GMD FDM NDGHEFLD

KKKKEFL O@J HHJGHJL. *2004+

1.4.9 !KKFLD FGJELGF GF @GO LG JGFK KRMJ, JKL , F L@

EHGJLF G JHGJLF MJL@J LLK K@GMD HJGN LG @D, QGMF

HJKGF GJ MDL O@G @K PHJF HGKKD JKL KRMJ, F L@J EDQ/

JJ/HJFL K HHJGHJL. @K FGJELGF K@GMD HJGN O@D L@

@D, QGMF HJKGF GJ MDL K OLF FGKK F K@GMD DKG

HJGN LG L@J EDQ F/GJ JJK. *2004+

1.5 Diagnosis

1.5.1 @ FGKK G HDHKQ F MDLK K@GMD KLDK@ Q KHDKL

ED HJLLGFJ OL@ LJFF F PHJLK F HDHKQ. *2004+

1.5.2 @ FGKK G HDHKQ F @DJF F QGMF HGHD K@GMD KLDK@

Q KHDKL HLJF OL@ LJFF F PHJLK F HDHKQ. *2004+

1.5.3 C@DJF, QGMF HGHD F MDLK F L@J EDK F/GJ JJK K@GMD

NF F GHHGJLMFLQ LG KMKK L@ FGKK OL@ F HHJGHJL @DL@JHJGKKGFD. *2004+

1.5.4 A LD @KLGJQ K@GMD LF JGE L@ @D, QGMF HJKGF GJ MDL F F

QOLFKK LG L@ LL, O@J HGKKD, LG LJEF O@L@J GJ FGL F

HDHL KRMJ K DDQ LG @N GMJJ. *2004+

1.5.5 @ DFD KGF K LG O@L@J F HDHL KRMJ @K GMJJ K@GMD

L@F K GF L@ GEFLGF G L@ KJHLGF G L@ LL F JFLKQEHLGEK. FGKK K@GMD FGL K GF L@ HJKF GJ KF G

KFD LMJK. *2004+

1.5.6 L EQ FGL HGKKD LG E FL FGKK G HDHKQ. L@ FGKK

FFGL DJDQ KLDK@, MJL@J FNKLLGFK (K KLGF 1.6) F/GJ

JJJD LG LJLJQ HDHKQ KHDKL8 (K JGEEFLGF 1.10.2) K@GMD

GFKJ. GDDGO-MH K@GMD DOQK JJF. *2004+



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1.5.7 @J FGF-HDHL LL KGJJK KMKHL, KMLD JJJD K@GMD

E LG HKQ@GDGD GJ HKQ@LJ KJNK GJ MJL@J FNKLLGF F

LJLEFL. *2004+

1.5.8 JGKHLN JGJF G NFLK, FDMF NG JGJF F OJLLF

KJHLGFK, F NJQ @DHMD F J@F FGKK. *2004+

1.6 Investigations

1.6.1 FGJELGF K@GMD HJGN LG @DJF, QGMF HGHD F MDLK F

EDK F/GJ JJK K HHJGHJL GF L@ JKGFK GJ LKLK, L@J JKMDLK F

EFF, L@ JIMJEFLK G KH FNKLLGFK, F L@ DGKLK G

GLFF L@E. *2004+

1.6.2 ADD FNKLLGFK GJ @DJF K@GMD HJGJE F @D-FLJ

FNJGFEFL. *2004+

E>


19/116

1.6.7 @ !!# K@GMD FGL MK LG PDM FGKK G HDHKQ F @D,

QGMF HJKGF GJ MDL F O@GE L@ DFD HJKFLLGF KMHHGJLK FGKK G

FGF-HDHL NFL. *2004+

1.6.8 @ !!# K@GMD FGL MK F KGDLGF LG E FGKK G HDHKQ.

*2004+

1.6.9 AF !!# EQ MK LG @DH LJEF KRMJ LQH F HDHKQ KQFJGE F

@DJF, QGMF HGHD F MDLK F O@GE HDHKQ K KMKHL. @K FDK

L@E LG NF L@ GJJL HJGFGKK. *2004+

1.6.10 F @DJF, QGMF HGHD F MDLK HJKFLF OL@ JKL MFHJGNGKRMJ, MFIMNGD HDHLGJE LNLQ K@GOF GF !!# F MK LG

KKKK L@ JK G KRMJ JMJJF. *2004+

1.6.11 GJ @DJF, QGMF HGHD F MDLK F O@GE HDHKQ K KMKHL, ML O@G

HJKFL FGKL MDLK, KHDKL FNKLLGFK K@GMD

NDD. *2004+

1.6.12 HL KLFJ !!#K EQ @DHMD O@F L@ FGKK G L@ HDHKQ GJL@ KQFJGE K MFDJ. $GONJ, L@ FGKK @K F KLDK@,

JHL !!#K J FGL DDQ LG @DHMD. *2004+

1.6.13 HL KLFJ !!#K K@GMD FGL MK F HJJF LG KDH GJ KDH-

HJN !!#K. *2004+

1.6.14 @F KLFJ !!# @K FGL GFLJML LG FGKK GJ DKKLGF,

KDH !!# K@GMD HJGJE. *2004+

1.6.15 F @DJF F QGMF HGHD, KDH !!# K KL @N L@JGM@ KDH

HJNLGF GJ L@ MK G EDLGFF10. *2004, 2012+

1.6.16 GF-LJE NG GJ EMDLGJQ !!# EQ MK F L@ KKKKEFL G

@DJF, QGMF HGHD F MDLK O@G HJKFL FGKL MDLK LJ

DFD KKKKEFL F KLFJ !!#. *2004+



MDF 137

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1.6.17 JGNGLGF Q KMKLGF EQ MK F L@ NDMLGF G FGF-HDHL

LL KGJJ. $GONJ, L @K DEL JGD F EQ D LG DK-HGKLN

JKMDLK F KGE HGHD. *2004+

1.6.18 @GL KLEMDLGF F @QHJNFLDLGF K@GMD JEF HJL G KLFJ !!#

KKKKEFL. @ @D, QGMF HJKGF GJ MDL F EDQ F/GJ JJ K@GMD

E OJ L@L KM@ LNLGF HJGMJK EQ FM KRMJ F L@Q

@N J@L LG JMK. *2004+

?


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!>< >=>=

1.6.26 KMJEFL G KJME HJGDLF K FGL JGEEF GJ L@ FGKK G

HDHKQ. *2004+

1.6.27 F MDLK, HHJGHJL DGG LKLK (GJ PEHD, HDKE DLJGDQLK, DMGK,

DME) LG FLQ HGLFLD MKK F/GJ LG FLQ FQ KFFL G-

EGJLQ K@GMD GFKJ. *2004+

1.6.28 F @DJF F QGMF HGHD, GL@J FNKLLGFK, FDMF DGG F MJF

G@EKLJQ, K@GMD MFJLF L L@ KJLGF G L@ KHDKL LG

PDM GL@J FGKK, F LG LJEF F MFJDQF MK G L@HDHKQ. *2004+

1.6.29 A 12-D !C# K@GMD HJGJE F MDLK OL@ KMKHL HDHKQ. *2004+

1.6.30 F @DJF F QGMF HGHD, 12-D !C# K@GMD GFKJ F KK G

FGKL MFJLFLQ. *2004+

1.6.31 F KK G FGKL MFJLFLQ, JJJD LG JGDGKL K@GMD

GFKJ. *2004+

?

1.6.32 *MJGHKQ@GDGD KKKKEFL K@GMD GFKJ F @DJF, QGMF

HGHD F MDLK F O@GE L K EHGJLFL LG NDML DJFF KDLK F

GFLN QKMFLGF, HJLMDJDQ F JJ LG DFM F EEGJQ. *2004+

1.6.33 JJD GJ FMJGHKQ@GDGD KKKKEFL K FL:

O@F @D, QGMF HJKGF GJ MDL OL@ HDHKQ K @NF MLGFD GJ

GMHLGFD MDLK

O@F F @K FL FGJEDLK F GFLNDQ EHGJLFL JF JGFK

O@F @D, QGMF HJKGF GJ MDL GEHDFK G EEGJQ GJ GL@J GFLN LK

F/GJ GFLN DF. *2004+



MDF 137



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1.7 Classification

1.7.1 !HDHL KRMJK F HDHKQ KQFJGEK F @DJF, QGMF HGHD F

MDLK K@GMD DKK MKF EMDL-PD FGKL K@E. @ PK

L@L K@GMD GFKJ J: KJHLGF G KRMJ (LD H@FGEFGDGQ);

KRMJ LQH; KQFJGE F LGDGQ. *2004+

1.7.2 @ KRMJ LQH(K) F HDHKQ KQFJGE, LGDGQ, F G-EGJLQ K@GMD

LJEF, MK DMJ LG DKKQ L@ HDHKQ KQFJGE GJJLDQ F

D LG FHHJGHJL LJLEFL F HJKKLF G KRMJK. *2004+

1.7.3 C@DJF, QGMF HGHD F MDLK OL@ HDHKQ K@GMD NF FGJELGF

GML L@J KRMJ LQH(K) F HDHKQ KQFJGE, F L@ DDQ HJGFGKK.

*2004+

1.8 Management

1.8.1 C@DJF, QGMF HGHD F MDLK OL@ HDHKQ K@GMD @N F KKD

HGFL G GFLL OL@ KHDKL KJNK. *2004+

1.8.2 ADD @DJF, QGMF HGHD F MDLK OL@ HDHKQ K@GMD @N

GEHJ@FKN J HDF L@L K J LOF L@ HJKGF, EDQ F/GJ

JJK O@J HHJGHJL, F HJEJQ J F KGFJQ J HJGNJK.

@K K@GMD FDM DKLQD KKMK K ODD K ED KKMK. *2004+

1.8.3 !HDHKQ KHDKL FMJKK (!*K) K@GMD F FLJD HJL G L@ FLOGJ G

J G @DJF, QGMF HGHD F MDLK OL@ HDHKQ. @ Q JGDK G L@

!*K J LG KMHHGJL GL@ HDHKQ KHDKLK F FJDKLK, LG FKMJKK LG GEEMFLQ F EMDL-FQ KJNK F LG HJGN FGJELGF,

LJFF F KMHHGJL LG L@ @D, QGMF HJKGF GJ MDL, EDK, JJK F, F

L@ K G @DJF, GL@JK FNGDN F L@ @D'K MLGF, ODJ F ODD-

F. *2004+

1.8.4 $DL@J HJGKKGFDK @N JKHGFKDLQ LG ML GL@JK GML

HDHKQ KG K LG JM L@ KLE KKGL OL@ L. @Q K@GMD HJGN

FGJELGF GML HDHKQ LG DD HGHD O@G GE FLG GFLL OL@ @DJF,



MDF 137

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QGMF HGHD F MDLK OL@ HDHKQ, FDMF K@GGD KL, KGD J

HJGKKGFDK F GL@JK. *2004+

1.9 Pharmacological treatment

*GL: K HHFP ! GJ MJL@J LDK G H@JEGDGD LJLEFL.

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L@ GFLPL G L@L HJGN Q L@ EFMLMJJ, GJ PEHD, FLGFK, K

LK F DF KLLMK. *2004+

1.9.1.2 @ A! LJLEFL KLJLQ K@GMD FNMDK GJF LG L@ KRMJ

LQH, HDHKQ KQFJGE, G-ELGF F G-EGJLQ, L@ @D, QGMF

HJKGF GJ MDL'K DKLQD, F L@ HJJFK G L@ HJKGF F L@J EDQ

F/GJ JJK K HHJGHJL (K HHFP !). *2004+

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KHL F GHLED GK G JKL-DF A!. *2004+



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F/GJ JJK K HHJGHJL, GFKJK L@L L@K K FGL GFJF. JFL

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LK. CGFKMDL L@ KMEEJQ G HJGML @JLJKLK (C) F 'BJLK@

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H@JEGFL HJGDK G FNMD A!K, ML FGL L@L L@K G FGL N

FGJELGF GF GEHJF GNDDLQ G JFL FJ HJHJLGFK11,12.

* 2012+

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OL@ KFD A! (EGFGL@JHQ) O@JNJ HGKKD. L@ FLD LJLEFL K

MFKMKKMD, L@F EGFGL@JHQ MKF FGL@J JM F LJ. CMLGF K

F MJF L@ @FGNJ HJG. *2004+

1.9.1.6 F A! @K D MK G NJK LK GJ GFLFM KRMJK,

KGF JM K@GMD KLJL (O@@ EQ F DLJFLN JKL-DF GJ

KGF-DF JM) F MDL MH LG F IML GJ EPEME LGDJL GK FL@F L@ JKL JM K@GMD LHJ G KDGODQ. *2004+

1.9.1.7 L@ KGF JM K MF@DHMD, L@J L@ JKL GJ KGF JM EQ LHJ,

HFF GF JDLN Q, K LK F @GO ODD L@ JMK J

LGDJL GJ KLJLF FGL@J JM. *2004+

1.9.1.8 L K JGEEF L@L GEFLGF L@JHQ (MFLN GJ '-GF' L@JHQ)

K@GMD GFDQ GFKJ O@F LLEHLK L EGFGL@JHQ OL@ A!K @N FGL

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HJKGF GJ MDL, F LJEK G HJGNF L@ KL DF LOF LNFKK

F JMF KRMJ JIMFQ F LGDJDLQ G K LK. *2004+

1.9.1.9 MKF JERHF, GJ GFLJGDD-JDK JERHF HJHJLGFK.

* 2012+



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FMJGNDGHEFLD EHJEFLK F F MFGJF @D, HJLMDJDQ OL@ @@

GKK G L@K A! GJ O@F MKF K HJL GHGDQL@JHQ. * 2012+

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GFJE, PHL F PHLGFD JMEKLFK L@L JIMJ KMKKGF F

JEFL LOF L@ HJKJJ, L@ KHDKL F L@ @D, QGMF HJKGF

GJ MDL F L@J EDQ F/GJ JJK K HHJGHJL. *2004+

1.9.2.2 A! L@JHQ K@GMD FLL F MDLK GF L@ JGEEFLGF G

KHDKL. *2004+

1.9.2.3 A! L@JHQ F @DJF F QGMF HGHD K@GMD FLL Q KHDKL.

*2004+

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LJ MDD KMKKGF G L@ JKK F FLK G LJLEFL. @K KMKKGF

K@GMD L FLG GMFL LDK G L@ HJKGF'K HDHKQ KQFJGE, HJGFGKK

F DKLQD. *2004+

1.9.2.5 JLEFL OL@ A! L@JHQ K FJDDQ JGEEF LJ KGF

HDHL KRMJ. *2004+

1.9.2.6 @F HGKKD, @GGK O@@ A! LG GJ GF L@ KK G L@ HJKFLF

HDHKQ KQFJGE. L@ HDHKQ KQFJGE K FGL DJ L HJKFLLGF, K

L@ KGF GF L@ HJKFLF KRMJ LQH(K). * 2012+

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F MDLK F L@J EDQ F/GJ JJK K HHJGHJL LJ JKL

MFHJGNG KRMJ :

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JF EF K@GOK KLJMLMJD FGJEDLQ. *2004+

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L@J EDK F/GJ JJK, F KGE FKLFK) EQ @GGK FGL LG L A!

L@JHQ GDDGOF MDD KMKKGF G L@ JKK F FLK. *2004+

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27/116

OJ G LJLGF JKK G KGME NDHJGL (K JGEEFLGF 1.9.1.10).

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LGDJL, KMKK OL@, GJ JJ LG, LJLJQ HDHKQ KHDKL. L@J A!K

L@L EQ GFKJ Q L@ LJLJQ HDHKQ KHDKL J KDJRHF

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NLJF F RGFKE14. CJMDDQ GFKJ L@ JKUFL JLG O@F

MKF NLJF MK G L@ JK G F JJNJKD L GF NKMD DK.

* 2012+

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= G%C =?@ >> = > G%C =?


28/116

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GJ NLJF. * 2012+

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JKHGFK GF !!#. B OJ G LJLGF JKK G KGME NDHJGL (K

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L@L DEGLJF F PJL EQGDGF KRMJK. ! K KMKHL K

JGEEFLGFK 1.9.13.1 F 1.9.13.2. * 2012+



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MFLN LJLEFL LG @DJF, QGMF HGHD F MDLK OL@ #! JKL-DF

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FLN GJ FGL LGDJL. B OJ G LJLGF JKK G KGME NDHJGL

(K JGEEFLGF 1.9.1.10). * 2012+

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DGRE14, DGFRHE GJ RGFKE14. * 2012+

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HJDF, LF GJ NLJF. * 2012+

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1.9.13.1J KGME NDHJGL K JKL-DF LJLEFL LG @DJF, QGMF HGHD F

MDLK OL@ FODQ FGK !, MFDKK L K MFKMLD. B OJ G

LJLGF JKK G KGME NDHJGL (K JGEEFLGF 1.9.1.10). *

2012+

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MFKMLD GJ FGL LGDJL. B OJ L@L LGHJEL @K DKK NGMJDK-L HJGD L@F DEGLJF, DNLJLE F KGME NDHJGL, F

L@L DEGLJF EQ PJL EQGDGF KRMJK. * 2012+

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MFLN LJLEFL LG @DJF, QGMF HGHD F MDLK OL@ ! JKL-DF

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LGDJL, KMKK OL@, GJ JJ LG, LJLJQ HDHKQ KHDKL F GFKJ

DGRE14, DGFRHE GJ RGFKE14. * 2012+

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HJDF, LF GJ NLJF. * 2012+

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FDM LDK G @GO KH JM @GK OJ E, JM GK, HGKKD

K LK, F LGF LG L KRMJK HJKKL. *2004+

1.9.17.3@ FK G L@ @D, QGMF HJKGF GJ MDL F L@J EDQ F/GJ JJK K

HHJGHJL K@GMD LF FLG GMFL O@F @DL@J HJGKKGFDK L

GF L@ JKHGFKDLQ G GFLFMF HJKJF. *2004+

1.9.17.4 EFEFL K KLJ@LGJOJ, GFLFMF A! L@JHQ F HJKJ F

HJEJQ J DGD JMEKLFK F/GJ DFKF DDGO. *2004+

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EDQ F/GJ JJK K HHJGHJL J MDDQ FGJE GML LJLEFL FDMF

LGF LG LF LJ EKK GK GJ LJ KLJGFLKLFD MHKL. *2004+

1.9.17.6 A@JF LG LJLEFL F GHLEK OL@ L@ GDDGOF:

MLF @DJF, QGMF HGHD F MDLK F L@J EDK F/GJ JJK F L@

MFJKLFF G L@J GFLGF F L@ JLGFD G LJLEFL

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MKF KEHD ELGF JEFK

HGKLN JDLGFK@HK LOF @DL@J HJGKKGFDK, L@ @D, QGMF HJKGF GJ

MDL OL@ HDHKQ F L@J EDQ F/GJ JJK. *2004+



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1.9.17.7MDJ DGG LKL EGFLGJF F MDLK K FGL JGEEF K JGMLF, F

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JGEEF K JGMLF, F K@GMD GF GFDQ DFDDQ FL F

JGEEF Q L@ KHDKL. *2004+

1.9.17.9 FLGFK GJ EGFLGJF G A! DGG DNDK J:

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KMKHL LGPLQ

MKLEFL G H@FQLGF GK

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2U3 EGFL@K) F GF JM K@GMD OL@JOF L LE. *2004+

1.9.18.5JLMDJ J K@GMD LF O@F OL@JOF FRGRHFK F

JLMJLK (EQ L MH LG 6 EGFL@K GJ DGFJ) MK G L@ HGKKDLQ G

JM-JDL OL@JOD KQEHLGEK F/GJ KRMJ JMJJF. *2004+

1.9.18.6@J K@GMD DK HDF J OL@ @DJF, QGMF HGHD F MDLKF L@J EDK F/GJ JJK K HHJGHJL, O@JQ KRMJK JMJ, L@

DKL GK JMLGF K JNJK F ED N K KGM@L. *2004+

1.10 Referral for complex or refractory epilepsy

1.10.1 ADD @DJF, QGMF HGHD F MDLK OL@ HDHKQ K@GMD @N KK N

L@J KHDKL LG LJLJQ KJN O@F JMEKLFK JIMJ. *2004+

1.10.2 KRMJK J FGL GFLJGDD F/GJ L@J K FGKL MFJLFLQ GJ LJLEFL

DMJ, @DJF, QGMF HGHD F MDLK K@GMD JJJ LG LJLJQ

KJNK KGGF9 GJ MJL@J KKKKEFL. JJD K@GMD GFKJ O@F

GF GJ EGJ G L@ GDDGOF JLJ J HJKFL:

L@ HDHKQ K FGL GFLJGDD OL@ ELGF OL@F 2 QJK

EFEFL K MFKMKKMD LJ LOG JMK



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L@ @D K MFJ 2 QJK

@D, QGMF HJKGF GJ MDL PHJFK, GJ K L JK G, MFHLD K LK

JGE ELGF

L@J K MFDLJD KLJMLMJD DKGF

L@J K HKQ@GDGD F/GJ HKQ@LJ G-EGJLQ

L@J K FGKL GML K LG L@ FLMJ G L@ KRMJK F/GJ KRMJ KQFJGE.

*2004+

1.10.3 F @DJF, L@ FGKK F EFEFL G HDHKQ OL@F L@ JKL O

QJK G D EQ PLJEDQ @DDFF. GJ L@K JKGF, @DJF OL@

KMKHL HDHKQ K@GMD JJJ LG LJLJQ KJNK JDQ, MK G L@

HJGGMF NDGHEFLD, @NGMJD F HKQ@GDGD LK L@L EQ

KKGL OL@ GFLFMF KRMJK. *2004+

1.10.4 B@NGMJD GJ NDGHEFLD JJKKGF GJ FDLQ LG FLQ L@ HDHKQ

KQFJGE F @D, QGMF HJKGF GJ MDL K@GMD JKMDL F EEL JJJD

LG LJLJQ KJNK. *2004+

1.10.5 C@DJF, QGMF HGHD F MDLK OL@ KH KQFJGEK KM@ K

LMJUJ KQFJGE, L@ @EKH@J KQFJGEK, KEMKKF'K

FH@DLK F @QHGL@DE @EJLGE K@GMD JJJ LG LJLJQ

HDHKQ KJN. *2004+

1.10.6 KQ@LJ G-EGJLQ F/GJ FLN KDF FNKLLGFK K@GMD FGL

GFLJFLGF GJ JJJD LG LJLJQ KJN18. *2004+

1.10.7 @ LJLJQ KJN K@GMD FDM EMDLKHDFJQ LE, PHJF F L@

KKKKEFL G @DJF, QGMF HGHD F MDLK OL@ GEHDP HDHKQ, F

@N IML KK LG FNKLLGFK F LJLEFL Q GL@ ED F

KMJD EFK. *2004+

1.10.8 @ PHJLK G EMDLKHDFJQ LEK FNGDN F EFF GEHDP

HDHKQ K@GMD FDM HKQ@GDGQ, HKQ@LJQ, KGD OGJ, GMHLGFD

L@JHQ, GMFKDDF, FMJGJGDGQ, DFD FMJK KHDKLK,



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FMJGH@QKGDGQ, FMJGDGQ, FMJGKMJJQ F FMJGFKL@K. EK

K@GMD @N F NG LDELJQ DLK NDD LG L@E. *2004+

1.10.9 @ FMJGKMJGF F L@ EMDLKHDFJQ LE K@GMD @N KHDKL

PHJF G F/GJ LJFF F HDHKQ KMJJQ F @N KK LG FNKN

!!# JGJF DLK. *2004+

1.10.10 FGJELGF K@GMD HJGN LG @DJF, QGMF HGHD F MDLK F

EDK F/GJ JJK K HHJGHJL GML L@ JKGFK GJ GFKJF

KMJJQ. @ FLK F JKK G L@ KMJD HJGMJ MFJ GFKJLGF

K@GMD MDDQ PHDF GJ FGJE GFKFL K GLF. *2004+

1.11 Psychological interventions

1.11.1 KQ@GDGD FLJNFLGFK (JDPLGF, GFLN @NGMJ L@JHQ,

G) EQ MK F GFMFLGF OL@ A! L@JHQ F MDLK O@J

L@J L@ HJKGF GJ L@ KHDKL GFKJK KRMJ GFLJGD LG FIML

OL@ GHLED A! L@JHQ. @K HHJG@ EQ KKGL OL@ F EHJGN

IMDLQ G D F KGE HGHD. *2004+

1.11.2 KQ@GDGD FLJNFLGFK (JDPLGF, GFLN @NGMJ L@JHQ) EQ

MK F @DJF F QGMF HGHD OL@ JM-JKKLFL GD HDHKQ. *2004+

1.11.3 KQ@GDGD FLJNFLGFK EQ MK K MFLN L@JHQ. @Q @N FGL

F HJGNF LG L KRMJ JIMFQ F J FGL F DLJFLN LG

H@JEGDGD LJLEFL. *2004+

1.12 Ketogenic diet

1.12.1 J @DJF F QGMF HGHD OL@ HDHKQ O@GK KRMJK @N FGL

JKHGF LG HHJGHJL A!K LG LJLJQ HLJ HDHKQ KHDKL GJ

GFKJLGF G L@ MK G LGF L. * 2012+



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1.13 Vagus nerve stimulation (VNS)

1.13.1 MK FJN KLEMDLGF K FL GJ MK K F MFLN L@JHQ F

JMF L@ JIMFQ G KRMJK F MDLK O@G J JJLGJQ LG FLHDHL

ELGF ML O@G J FGL KMLD GJ JKLN KMJJQ. @K FDMK MDLK

O@GK HDHL KGJJ K GEFL Q GD KRMJK19 (OL@ GJ OL@GML

KGFJQ FJDKLGF) GJFJDK KRMJK. *2004, 2012+

1.13.2 MK FJN KLEMDLGF K FL GJ MK K F MFLN L@JHQ F

JMF L@ JIMFQ G KRMJK F @DJF F QGMF HGHD O@G J

JJLGJQ LG FLHDHL ELGF ML O@G J FGL KMLD GJ JKLN

KMJJQ. @K FDMK @DJF F QGMF HGHD O@GK HDHL KGJJ K

GEFL Q GD KRMJK19 (OL@ GJ OL@GML KGFJQ FJDKLGF) GJ

FJDK KRMJK20. *2004, 2012+

1.14 Prolonged or repeated seizures and convulsive status

epilepticus

1.14.1 F- >> < = >

; < )

=? ?>

1.14.1.1#N EEL EJFQ J F LJLEFL LG @DJF, QGMF HGHD F

MDLK O@G @N HJGDGF (DKLF 5 EFMLK GJ EGJ) GJ JHL (L@J GJ

EGJ F F @GMJ) GFNMDKN KRMJK F L@ GEEMFLQ. *2012+

1.14.1.2FDQ HJKJ MD ERGDE GJ JLD RHE21 GJ MK F L@

GEEMFLQ GJ @DJF, QGMF HGHD F MDLK O@G @N @ HJNGMKHKG G HJGDGF GJ KJD GFNMDKN KRMJK. * 2012+

1.14.1.3AEFKLJ MD ERGDE K JKL-DF LJLEFL F @DJF, QGMF HGHD

F MDLK OL@ HJGDGF GJ JHL KRMJK F L@ GEEMFLQ. AEFKLJ

JLD RHE21 HJJJ GJ MD ERGDE K FGL NDD.

FLJNFGMK KK K DJQ KLDK@ F JKMKLLGF DLK J

NDD, EFKLJ FLJNFGMK DGJRHE. * 2012+



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1.14.1.4JLEFL K@GMD EFKLJ Q LJF DFD HJKGFFD GJ, KH

Q F FNMDDQ J HJGLGGD JOF MH OL@ L@ KHDKL, Q EDQ

EEJK GJ JJK OL@ HHJGHJL LJFF. *2004+

1.14.1.5CJ EMKL LF LG KMJ L@ @D, QGMF HJKGF GJ MDL'K JOQ F

KKKK @K GJ @J JKHJLGJQ F J MFLGF. *2004+

1.14.1.6HFF GF JKHGFK LG LJLEFL, L@ HJKGF'K KLMLGF F FQ

HJKGFDK J HDF, DD F EMDF, HJLMDJDQ :

L@ KRMJ K GFLFMF 5 EFMLK LJ L@ EJFQ ELGF @K F

EFKLJ

L@ HJKGF @K @KLGJQ G JIMFL HKGK G KJD KRMJK GJ @K GFNMDKN

KLLMK HDHLMK, GJ L@K K L@ JKL HKG JIMJF EJFQ LJLEFL


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1.14.2.2AEFKLJ FLJNFGMK DGJRHE K JKL-DF LJLEFL F @GKHLD F @DJF,

QGMF HGHD F MDLK OL@ GFGF FJDK LGFUDGF KRMJK

(GFNMDKN KLLMK HDHLMK). AEFKLJ FLJNFGMK RHE FLJNFGMK

DGJRHE K MFNDD, GJ MD ERGDE MFD LG KMJ EEL

FLJNFGMK KK. AEFKLJ EPEME G LOG GKK G L@ JKL-DF

LJLEFL (FDMF HJ-@GKHLD LJLEFL). DKG L@ KMKL HJGLGGDK

F HHFP . * 2012+

1.14.2.3 KRMJK GFLFM, EFKLJ FLJNFGMK H@FGJLD GJ H@FQLGF K

KGF-DF LJLEFL F @GKHLD F @DJF, QGMF HGHD F MDLK OL@

GFGF FJDK LGFUDGF KRMJK (GFNMDKN KLLMK HDHLMK).

DKG L@ KMKL HJGLGGDK F HHFP . * 2012+

#>?= ;;>?=

1.14.2.4GDDGO L@ KMKL HJGLGGDK F HHFP GJ LJLF JJLGJQ GFNMDKN

KLLMK HDHLMK F KGFJQ J. *2012+

1.14.2.5AEFKLJ FLJNFGMK ERGDE21, HJGHGGD21 GJ L@GHFLD KGME21 LG LJL

MDLK OL@ JJLGJQ GFNMDKN KLLMK HDHLMK. AIML EGFLGJF,

FDMF DGG DNDK G A!K, F JLD D KQKLEK KMHHGJL J JIMJ.

DKG L@ KMKL HJGLGGDK F HHFP . * 2012+

1.14.2.6AEFKLJ FLJNFGMK ERGDE21 GJ L@GHFLD KGME21 LG LJL @DJF

F QGMF HGHD OL@ JJLGJQ GFNMDKN KLLMK HDHLMK. AIML

EGFLGJF, FDMF DGG DNDK G A!K, F JLD D KQKLEK KMHHGJL J

JIMJ. DKG L@ KMKL HJGLGGDK F HHFP . *2012+

1.14.2.7AK L@ LJLEFL HL@OQ HJGJKKK, L@ PHJLK G F FKL@LKL/

FLFKNKL K@GMD KGM@L. *2004+

1.14.2.8 L@J L@ O@GD HJGLGGD GJ FLFKN J K JIMJ L@ LJLJQ KJN

K@GMD GFKMDL. *2004+

1.14.2.9MDJ A!K K@GMD GFLFM L GHLED GKK F L@ JKGFK GJ KLLMK

HDHLMK K@GMD FNKLL. *2004+



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1.14.2.10AF FNMD LJLEFL HL@OQ K@GMD GJEMDL GJ @DJF, QGMF

HGHD F MDLK O@G @N JMJJFL GFNMDKN KLLMK HDHLMK. *2004+

1.14.3 -@?=@ =>>?= ;;>?=

1.14.3.1*GF-GFNMDKN KLLMK HDHLMK K MFGEEGF F EFEFL K DKK

MJFL. A KMKL MDF F GMF F HHFP . *2004+

1.15 Women and girls with epilepsy

1.15.1 I @ < ;;=

1.15.1.1 F GJJ LG FD FGJE KGFK F @G, F LG JM

EKMFJKLFFK, OGEF F JDK OL@ HDHKQ F L@J HJLFJK, K

HHJGHJL, EMKL NF MJL FGJELGF F GMFKDDF GML

GFLJHLGF, GFHLGF, HJFFQ, JF GJ @DJF F JKLF,

F EFGHMK. *2004+

1.15.1.2 FGJELGF GML GFLJHLGF, GFHLGF, HJFFQ, GJ EFGHMK K@GMD

NF LG OGEF F JDK F NF G KPMD LNLQ, HJFFQ GJ

EFGHMK, F L@ FGJELGF K@GMD LDGJ LG L@J FNMD FK.

@K FGJELGF K@GMD DKG NF, K F, LG HGHD O@G J DGKDQ

FNGDN OL@ OGEF F JDK OL@ HDHKQ. @K EQ FDM @J EDQ F/

GJ JJK. *2004+

1.15.1.3ADD @DL@J HJGKKGFDK O@G LJL, J GJ, GJ KMHHGJL OGEF F JDK

OL@ HDHKQ K@GMD EDJ OL@ JDNFL FGJELGF F L@ NDDLQ G

GMFKDDF. *2004+

1.15.1.4KMKK OL@ OGEF F JDK G @DJF HGLFLD (FDMF QGMF JDK

O@G J DDQ LG F LJLEFL FLG L@J @DJF QJK), F L@J

HJFLK F/GJ JJK HHJGHJL, L@ JK G A!K MKF EDGJELGFK

F HGKKD FMJGNDGHEFLD EHJEFLK F F MFGJF @D. AKKKK L@

JKK F FLK G LJLEFL OL@ FNMD JMK. @J J DEL L GF

JKK LG L@ MFGJF @D KKGL OL@ FOJ JMK. HDDQ KMKK L@

JK G GFLFM MK G KGME NDHJGL LG L@ MFGJF @D, F OJ L@L



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@@J GKK G KGME NDHJGL (EGJ L@F 800 E/Q) F HGDQL@JHQ,

HJLMDJDQ OL@ KGME NDHJGL, J KKGL OL@ JLJ JK. * 2012+

1.15.1.5B OJ G L@ DLKL L GF L@ JKK LG L@ MFGJF @D KKGL OL@

A! L@JHQ O@F HJKJF GJ OGEF F JDK G HJKFL F MLMJ

@DJF HGLFLD. *2012+

1.15.1.6ADD OGEF F JDK GF A!K K@GMD GJ 5 E HJ Q G GD

GJ FQ HGKKDLQ G HJFFQ. *2004+

1.15.1.7J LG L@ C F B* (NDD L @LLH://F.GJ) GJ FNMD JM

N GF L@ FLJLGFK LOF A!K F @GJEGFD JHDEFL FGFLJHLGF. * 2012+

1.15.2 C>

1.15.2.1 F OGEF G @DJF HGLFLD, L@ HGKKDLQ G FLJLGF OL@ GJD

GFLJHLNK K@GMD KMKK F F KKKKEFL E K LG L@ JKK

F FLK G LJLEFL OL@ FNMD JMK. *2004+

1.15.2.2 F JDK G @DJF HGLFLD, FDMF QGMF JDK O@G J DDQ LG F

LJLEFL FLG L@J @DJF QJK, L@ HGKKDLQ G FLJLGF OL@ GJD

GFLJHLNK K@GMD KMKK OL@ L@ @D F/GJ @J JJ, F F

KKKKEFL E K LG L@ JKK F FLK G LJLEFL OL@ FNMD

JMK. *2004+

1.15.2.3 F OGEF F JDK G @DJF HGLFLD, L@ JKK F FLK G JFL

GFLJHLN EL@GK, FDMF @GJEGF-JDKF K, K@GMD

KMKK. *2004+

1.15.2.4 OGEF GJ JD LF FRQE-FMF A!K @GGKK LG L L@ GEF

GJD GFLJHLN HDD, MF GML GK K@GMD KGM@L JGE L@ C

F MJJFL LGF G L@ B* (NDD L @LLH://F.GJ). *2004,

2012+

1.15.2.5@ HJGKLGF22-GFDQ HDD K FGL JGEEF K JDD GFLJHLGF F

OGEF F JDK LF FRQE-FMF A!K. *2004, 2012+



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1.15.2.6@ HJGKLGF22 EHDFL K FGL JGEEF F OGEF F JDK LF

FRQE-FMF A!K. *2004, 2012+

1.15.2.7@ MK G LGFD JJJ EL@GK K@GMD KMKK OL@ OGEF F

JDK LF FRQE-FMF A!K F GJD GFLJHLGF GJ @NF HGL

FLGFK G HJGKLGF22. *2004, 2012+

1.15.2.8 EJFQ GFLJHLGF K JIMJ GJ OGEF F JDK LF FRQE-

FMF A!K, L@ LQH F GK G EJFQ GFLJHLGF K@GMD F

DF OL@ L@ C F MJJFL LGF G L@ B* (NDD L @LLH://F.GJ).

*2004, 2012+

1.15.2.9KMKK OL@ OGEF F JDK O@G J LF DEGLJF L@L L@ KEMDLFGMK

MK G FQ GKLJGF-K GFLJHLN F JKMDL F KFFL JMLGF

G DEGLJF DNDK F D LG DGKK G KRMJ GFLJGD. @F OGEF GJ JD

KLJLK GJ KLGHK LF L@K GFLJHLNK, L@ GK G DEGLJF EQ F

LG MKL. * 2012+

1.15.3 "


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1.15.3.5GEF F JDK K@GMD JKKMJ L@L L@J K FG NF L@L GD19,

KF F EQGDGF KRMJK L L@ HJFFQ GJ NDGHF LMK

NJKDQ MFDKK L@Q DD F KMKLF F FMJQ. *2004, 2012+

1.15.3.6GEF F JDK K@GMD JKKMJ L@L F FJK F KRMJ JIMFQ K

FJDDQ MFDDQ F HJFFQ GJ F L@ JKL O EGFL@K LJ JL@. *2004+

1.15.3.7#FJDDQ, OGEF F JDK EQ JKKMJ L@L L@ JK G LGFUDGF

KRMJ MJF L@ DGMJ F L@ 24 @GMJK LJ JL@ K DGO (1U4%). *2004+

1.15.3.8GEF F JDK OL@ HDHKQ K@GMD FGJE L@L DL@GM@ L@Q J DDQ

LG @N @DL@Q HJFFK, L@J JK G GEHDLGFK MJF HJFFQ FDGMJ K @@J L@F GJ OGEF F JDK OL@GML HDHKQ. *2004+

1.15.3.9CJ G HJFFL OGEF F JDK K@GMD K@J LOF L@ GKLLJF

F L@ KHDKL. *2004+

1.15.3.10JFFL OGEF F JDK O@G J LF A!K K@GMD GJ @@-

JKGDMLGF MDLJKGMF KF LG KJF GJ KLJMLMJD FGEDK. @K KF K@GMD

HJGJE L 18U20 OK' KLLGF Q F HHJGHJLDQ LJFMDLJKGFGJH@J, ML JDJ KFFF EQ DDGO EGJ EDGJELGFK LG

LL KGGFJ. *2004+

1.15.3.11@ JK G KRMJK MJF DGMJ K DGO, ML L K KMFL LG OJJFL L@

JGEEFLGF L@L DNJQ K@GMD L HD F F GKLLJ MFL OL@

DLK GJ ELJFD F FGFLD JKMKLLGF F LJLF ELJFD

KRMJK. *2004+

1.15.3.12ADD @DJF GJF LG EGL@JK LF FRQE-FMF A!K K@GMD NF

1 E G NLEF HJFLJDDQ L DNJQ. *2004+

1.15.3.13#FL GMFKDDF K@GMD GFKJ GF HJLFJ @K HDHKQ,

HJLMDJDQ L@ HJLFJ @K GHL@ HDHKQ F HGKLN EDQ @KLGJQ G

HDHKQ. *2004+



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http://publications.nice.org.uk/sthe-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-cg137/appendix-g-abbreviations-and-glossary#tonicclonic-seizurehttp://publications.nice.org.uk/sthe-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-cg137/appendix-g-abbreviations-and-glossary#tonicclonic-seizurehttp://publications.nice.org.uk/sthe-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-cg137/appendix-g-abbreviations-and-glossary#genetic-with-reference-to-epilepsyhttp://publications.nice.org.uk/sthe-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-cg137/appendix-g-abbreviations-and-glossary#genetic-with-reference-to-epilepsyhttp://publications.nice.org.uk/sthe-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-cg137/appendix-g-abbreviations-and-glossary#tonicclonic-seizurehttp://publications.nice.org.uk/sthe-epilepsies-the-diagnosis-and-management-of-the-epilepsies-in-adults-and-children-in-primary-cg137/appendix-g-abbreviations-and-glossary#tonicclonic-seizure


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1.16 Children, young people and adults with learningdisabilities (see also sections

Epilepsi - NICE

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