What do we do?

We are one of the four national centres for Children's Epilepsy Surgery Services (CESS) in England, and assess children under 18-years-of-age with epilepsy that might benefit from epilepsy surgery. More information on this nationally commissioned service can be seen in this Epilepsy Action leaflet (please click on the document below).

Contacts:

Epilepsy Surgery Specialist Nurses: CESSnurses@uhbw.nhs.uk /0117 342 7935 / 0117 342 7934

Epilepsy surgery Coordinator: Darren.Shepherd@uhbw.nhs.uk / 0117 342 0897

Neuropsychology: 0117 3427894

Neuropsychiatry:

Video monitoring: 0117 3428664

Neurosurgery secretary: 0117 3428585

CESS programme assessment involves multiple teams, most of whom are at Bristol Royal Hospital for Children:

Referrals by paediatricians or paediatric neurologists should be made using the Orion portal: Make a referral | ORION.

The team are happy to receive letters and notes alongside this Orion referral, but new cases must be added to this system. The Orion system will automatically update referrers with progress through the system - we suggest the lead referring consultant and child's lead local epilepsy specialist nurse are both entered during referral.

Referral queries can be directed to the CESS coordinator Darren Shepherd (Darren.Shepherd@uhbw.nhs.uk).

We are happy to accept referrals for children aged under 18-years for pre-surgical evaluation. Children with any of the following crieria should be referred:

All children under the age of 24months with suspected focal seizure onset with or without identifiable lesion on brain MRI including those with catastrophic onset epilepsy and developmental regression. (All children under the age of 24 months should have a paediatric neurologist involved in their care).
All children of any age with seizures and unilateral lesions on MRI, i.e. cortical malformation, developmental tumour, acquired brain injury, hippocampal sclerosis.
Certain aetiologies and constellations require special consideration including Sturge Weber syndrome, unilateral structural brain lesions (i.e. cortical dysplasia or developmental tumours) associated with developmental regression +/- continued seizures, Rasmussen syndrome, hypothalamic hamartoma
All children of any age with medication resistant seizures suggestive of focal onset and no identifiable lesion on MRI, that have failed treatment with two or more anti-seizure medications
Children of any age with Tuberous Sclerosis with seizures resistant to two anti-seizure medications should be evaluated to see if seizures arise from resectable tubers located in one hemisphere.
Children who have 'drop attacks' as part of a more complex epilepsy, with or without structural brain abnormalities, may also be suitable for corpus callosotomy.
Children with epilepsy resistant to medications who may benefit from a vagal nerve stimulator, who do not otherwise meet the other criteria.

What we do