- Pre-ictal:
- Onset: when? First time? How it started? What were you doing?
- Timing & frequency: duration? Intermittent\continuous? How frequent?
- Triggers: flashing lights? Sleep-deprivation? Emotions\stress?
- Warning signs: change in vision\hearing\smell? Disturbance of memory? Light-headed and nausea? Sweating, confused, weakness? Palpitations, facial flushing? Intense fear?
- Peri-ictal:
- Were you alone or did someone see you? Do you remember?
- Loss of consciousness? Were you sitting or standing? Did you fall down (if so, how)?
- Head tilt\eye deviation to one side? Jerking movements (where, uni\bi-lateral)? Repetitive movements (lip smacking, chewing)?
- Rolling of the eyes? Frothing of the mouth? Change in color during the event?
- Any injuries? Did the you bite your tongue? Did you lose control over your urine\bowel?
- Post-ictal:
- How quick did you recover?
- Confused, drowsy, sleepy, weakness, headache, speech problems?
- Associated Sx:
- Constitutional: fever, fatigue, wt loss, loss of appetite, night sweats, chills?
- Neurological: blurred vision, numbness, weakness?
- Meningitis: stiff neck, headache, vomiting, rash?
- Psych: loss of interest, low mood, anxiety\stress, suicide risk assessment?
- PMHx:
- Diseases:
- Chronic ds (HTN, DM, DLP)
- Febrile seizures? Previous episodes? Was it the same? Describe it?
- Neurological ds, brain tumors, infections
- Medications: (anti-convulsant) -> ask about dose, route, frequency, response, compliance, SE
- Surgery, hospitalization, trauma (esp head)
- Blood transfusions, IV drug use, tattoos
- Allergies
- Diseases:
- If pediatric pt:
- Birth:
- Prenatal: healthy pregnancy, complications, infections?
- Natal: mode of delivery, term\preterm?
- Post-natal: NICU admissions, complications?
- Immunizations: ask for immunization card, up to date?
- Nutritional Hx:
- Developmental Hx
- Birth:
- FMHx:
- Similar complaint?
- Same diseases as in PMHx?
- Social Hx:
- Occupation, marital status, children?
- Smoking, alcohol, recreational drugs?
- Travel Hx, contact with sick pts
- Diet, exercise