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CLINICAL CASEBOOK - A publican worried about trembling hands

Epilepsy patients managed in primary care frequently miss out on specialist assessment and advice, new research concludes.

A GP audit found around 56 per cent of adults with epilepsy had never received specialist assessment, and a significant proportion were misdiagnosed or not treated optimally.

Study researcher Ruth Lauder, service co-ordinator for the epilepsy service in North Wales, said: ‘We've always known it's a big problem. The problem is there aren't specialist units in many areas of the country.'

Dr Henry Smithson, a GP in York and chair of the NICE epilepsy guidance group, said: ‘This reinforces the difficulties in accessing scarce neurology services in the UK. Service redesign must involve a locally developed service between primary and secondary care.'

Of patients from 26 practices invited for specialist review, 41 per cent attended and just 19 per cent of these had previously seen a neurologist.

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