What is the study about?

National Audit of Pathways in Epileptic Seizure Referrals (NAPIER) is a retrospective multicentre audit of first seizure management throughout the UK and Ireland. It will aim to include 1500 patients with suspected first seizures from over 50 centres.

A first seizure may signal the onset of new epilepsy, previously undiagnosed epilepsy, or an underlying illness. Following a single unprovoked seizure, the risk of recurrence is greatest in the first 3-6 months, prompting the development of national guidelines setting standards of care for the management of first seizures.

NICE have set recommendations for suspected epileptic seizures to be assessed within two weeks by a neurologist or epilepsy specialist. This has led to the emergence of first seizure clinics and rapid referral pathways within hospitals. NAPIER sets out to explore variations in these services with the view of setting national standards that are required to fulfil recommendations. Please consult the protocol for further details.

How can I get involved?

Medical students or junior doctors based in the UK or Ireland are welcome to join as regional collaborators. Please register using the link below:


Click the logo for the protocol

What are the next steps?




Late September/early October

Steering committee to finalise protocol


Regional collaborators to receive instructions on how to register the audit with their hospital and gain local approval.


November – March

Data collection. Regional collaborators to receive instructions on how to upload data onto the REDCap online database and maintain patient confidentiality.


March – July

Data analysis and interpretation. Regional collaborators encouraged to present results to their local clinical neuroscience MDT.


Any queries?

David Lee

NANSIG Vice Chair of Research

Academic FY2 Doctor (NHS Grampian) /

In collaboration with: