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of everyone affected by epilepsy

Call for more services for people with epilepsy

4 March, 2002

An editorial in the British Medical Journal claims that the high rate of misdiagnosis is a strong argument for improved care for people with epilepsy.

The editorial, entitled "The misdiagnosis of epilepsy", was written by doctors David Chadwick and David Smith, from the Walton Centre for Neurology and Neuroscience in Liverpool, and highlighted the recent case of Dr Andrew Holton, consultant paediatrician at Leicester Royal Infirmary, who has been suspended and referred to the General Medical Council after a review of 214 children seen by him showed that 171 gave definite or possible "cause for concern".

The authors write:

"The review also made clear that Dr Holton's training fell well short of what would be required for his post. Although a consultant in paediatrics, Dr Holton was not a paediatric neurologist, of whom there are just 62 in the United Kingdom. The report also points to professional isolation and under-resourcing as important mitigating factors in Dr Holton's practice. This episode graphically illustrates the potential consequences of the shortcomings identified in 2000 by the Clinical Standards Advisory Group in its report on epilepsy services in the United Kingdom."

The editoral admits that:

"Though the diagnosis of seizures and epilepsy can be straightforward, it can also be one of the greatest clinical challenges". 

The doctors conclude:

"We can no longer accept the delivery of epilepsy care from an unsupported general physician or paediatrician... The poor quality of epilepsy services and the preventable mortality of epilepsy have recently been highlighted in the chief medical officer's annual report and commitments made to address these issues. It must now be evident that the human and financial costs of failing to implement the recommendations are too high to be acceptable."