Seizure History

• 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

• 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

• 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

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