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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