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When should I consider referring a patient with temporal lobe epilepsy to a

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MSt MRCGP.

Posted: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed

You should consider referring a patient with temporal lobe epilepsy to a neurologist for further evaluation in several key situations:

  • Seizure Recurrence: Refer urgently (within 2 weeks) if the patient experiences a seizure recurrence after a period of remission .
  • Ongoing Seizures and Unclear Diagnosis: If seizures are ongoing despite treatment and the diagnosis remains unclear, consider an additional review of MRI scans by a specialist in paediatric or adult neuroradiology within a tertiary centre .
  • New Features: Consider an additional MRI scan if there are new features to their epilepsy . This would typically warrant specialist review.
  • Considering Surgery: An additional MRI scan should be considered if surgery is being considered for their epilepsy .
  • Genetic Testing: Discuss with a neurologist or geneticist any uncertainties about whether to offer genetic testing or which tests to offer to a person with epilepsy .

Initial referral for a first suspected seizure, or for features strongly suggestive of epileptic seizures (such as a bitten tongue, head-turning to one side during transient loss of consciousness, or confusion following the event), should also be made urgently to a clinician with expertise in assessing first seizures and diagnosing epilepsy ,.

Educational content only. Always verify information and use clinical judgement.

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