You should refer in the following circumstances:

• If you come across a person with epilepsy who has never been treated.
• If you suspect a person is having a seizure for the first time and is above the age of 40 years.
• If the seizure occurs in a child under two years of age.
• If the person is pregnant.
• If there has been a recent increase in the frequency of seizures, despite the use of AED medication and in the absence of any explanation.
• If you suspect status epilepticus.
• If there is evidence of psychiatric illness (requiring psychiatric drug treatment).
• If there are severe side effects.