Background Epilepsy is the most common, chronic neurological condition with a prevalence of 0.5% and an incidence of 3 to 5%. Despite anticonvulsant use, there are approximately 60,000 A&E attendances and 40,000 hospital admissions.

Method Using A&E triage records a list of all patients attending St George’s Hospital A&E department with a seizure within a six month period was derived. By referring to clinical records, management in A&E and beyond was audited according to NICE guidelines.

Results 382 adults with seizures were identified. 33% attended A&E in the previous 12 months with a seizure. Of those with epilepsy (n=187), 9% were on no drug. In all seizure cases, documentation was often incomplete and a collateral history was only obtained in 44% cases. 44% of patients were admitted, and of these, 15% were unnecessary according to criteria outlined by Iyer et al. Only 8% were asked if they were a driver and alcohol intake was not documented in 44%. Only 37% were referred to a neurologist or epilepsy specialist.

Conclusion Seeing as a third of the patients attended A&E in the previous 12 months, it is clear that thorough history taking and better management in the community is necessary.