Care process for severe epileptic seizures in the Community of Madrid: The Seizures Code

The Urgent Epileptic Seizures Care Process (UESP), also known as the Seizure Code, is a care process implemented in the Community of Madrid with the objective of standardizing and optimizing the urgent management of epileptic seizures (ESs) in pediatric and adult patients.

The aim of this care process, which is based on the recommendations of the national consensus guideline in Spain and international guidelines, is to standardize the diagnosis, treatment, and follow-up of severe ESs across all levels of care. It was developed through a multidisciplinary collaborative effort involving professionals in emergency medicine, intensive care, neurophysiology, pediatric neurology, and primary care, and was structured into twelve sub-processes reviewed and endorsed by Spanish scientific societies.

The Seizures Code establishes operational criteria for activation and defines specific algorithms for management in different clinical settings. It includes intervention times, therapeutic sequences with early and systematic use of benzodiazepines and early combination therapy with antiseizure medications, as well as strategies for coordination between care levels. It also promotes early use of electroencephalography (EEG), ongoing training for health care professionals and families, and a standardized registry of care activity.

The Seizure Code is the first comprehensive model for urgent management of severe ESs implemented in a Spanish autonomous community. Its design promotes an early, homogeneous, and evidence-based response, with particular impact on the pediatric population. It enhances interhospital coordination and therapeutic adherence and is a dynamic tool that supports continuous evaluation and improvement of care quality in pediatric neurology.