Epilepsy DIARY. - PDF Free Download

Epilepsy DIARY www.epilepsyscotland.org.uk

NAME: Address: Important contact details I have epilepsy This is what usually happens during a seizure and if I have a seizure, this is what you can do to help: Tel no: EMERGENCY CONTACT: Relationship to patient: Address: Tel no: GP: Surgery address: Tel no: CONSULTANT: Hospital: Tel No: Email: EPILEPSY SPECIALIST NURSE: Tel no: Email: If I have a seizure please: Time the seizure: if it lasts for more than minutes please call an ambulance. Clear a space around me and keep me safe. Put something soft under my head. Turn me onto my side once the convulsions have stopped. Stay with me until I have regained consciousness. DO NOT: DO NOT move me unless I am in danger. DO NOT restrain or lift me. DO NOT put anything in my mouth. DO NOT give me a drink until I am fully conscious. DO NOT call an ambulance unless: My seizure lasts for more than minutes. There is a concern about my breathing. I have injured myself beyond first aid. You think I may have inhaled fluid. My medication: Thanks for staying with me.

What is this diary for? A seizure diary allows you to record information about your epilepsy. This can help you, your family, and your health care team keep track of important information such as types of seizures, seizure frequency, possible seizure triggers and patterns, and any possible side effects of your anti-epileptic drugs. This information can help you manage your epilepsy better, and can help your doctor, epilepsy specialist nurse or consultant decide on the best treatment plan. How to use this seizure diary The first step is to identify the different types of seizures you experience. Use a letter to represent each type of seizure, ranging from A as the least severe, to D as the most severe. Your doctor, epilepsy specialist nurse or consultant may be able to help you with this. Types of seizure experienced Write down your own seizure classification, starting with the least severe type. You can include how you feel before, during and after a seizure, and how long the seizure type usually lasts. Remember that you may only experience one type of seizure. Use the Additional seizure information box overleaf if you need more space. A B A B C D For example: Feeling of butterflies in stomach. Feeling of losing time, smacking lips and pulling at clothes. Seizure A followed by falling over, becoming rigid, followed by jerking movements. Seizure lasting no more than minutes. A + C together lasting for more than minutes. NOTE: You will use these letters to record your seizures in the diary. This way you don t have to write a long description each time. C D

What should I record? You should try to record as much information as possible. This will help build up a bigger picture and can help you and your health care team manage your epilepsy better. It may, for example, help identify specific seizure triggers. If you can work on these triggers, you may be able to reduce the frequency of your seizures. To use the diary: Fill in the month at the top of the page. Use your seizure classification overleaf to record how many of each type of seizure you experience. Use the awake and asleep columns. Note the time of each seizure. Make a note of any possible seizure triggers. These may be unique to you, but common seizure triggers include missed medication, stress, skipping meals, dehydration, lack of sleep, alcohol/binge drinking, menstruation, changes to medication and flashing lights. In the notes section record anything else that may be relevant. Include medication changes and any other medication you may be taking, alongside information about your general health and your mood. For example: feeling stressed, run down or ill, or being in a good or bad mood. All these things can affect your epilepsy. You can also include information on any possible side effects of your anti-epileptic drugs. Month: January 1 1A 10am Skipped breakfast Reduced Keppra to 250mg as directed 2 1C? Felt groggy in morning, bit tongue 4 2B 10/11am Period started Took paracetamol 1x500mg at 4pm Additional seizure information There is space at the back of the diary to write down: Detailed information about your epilepsy medication. Information on any other medicine you are taking (supplements, over-the-counter and prescribed medications). Your appointment record. A list of questions you may want to ask your doctor, epilepsy specialist nurse or consultant.

Seizure Diary Month: 1 2 4 5 6 7 8 9 10 11 12 1 14 15 16 17 18 19 20 21 22 2 24 25 26 27 28 29 0 1 Total

Epilepsy medication Use this section to keep a record of your anti-epileptic drugs. Include the name, dosage and any dose adjustments, and the date you started/stopped the medication. In the comments box, record any special instructions like take with food, along with the reason any medication was stopped. Also note any changes to your medication, such as dosage changes or if you alter the time of day you take your medication and any side effects you may experience. Other medications Keep a note of any other medications you take. Include prescribed medications, supplements, and over-the-counter medications. This information is important because some medicines should not be taken together. Include the name, dosage, when the medication was started/stopped and any other comments.

Appointment Record Date Time Doctor/Specialist Location Questions I may want to ask my doctor or epilepsy specialist List any possible side effects of your anti-epileptic drug(s) 1 1 2 2

Helpline: 0808 800 2200 Text: 07786 209 501 Email: helpline@epilepsyscotland.org.uk www.epilepsyscotland.org.uk Epilepsy Scotland 48 Govan Road, Glasgow, G51 1JL General: 0141 427 4911 Fax: 0141 419 1709 Email: enquiries@epilepsyscotland.org.uk Epilepsy Action Scotland is a company limited by guarantee. Registered in Scotland No 16987 Scottish Charity: No SC000067 Follow us on Facebook and Twitter Epilepsy Scotland @epilepsy_scot Phe/PAI/1/097 - October 201