Table.
RedCap Data Elements
Question |
Does the patient have an epilepsy diagnosis? |
Was SUDEP discussed at this visit? |
Was the patient counselled on driving with epilepsy at this visit? |
Was the patient screened for anxiety and/or depression at this visit? |
Was the patient counselled regarding water safety at this visit? |
Was the patient/caregiver counselled on epilepsy, and how its treatment may affect contraception and/or pregnancy? |
For infantile spasms—what treatment was given as first line? |
Did the patient have a normal physical examination? |
If the patient's examination was abnormal, please list findings here: |
When was the patient's last generalized tonic-clonic seizure? |
Recently, what is the frequency of generalized tonic-clonic seizures? |
In the past 12 mo, have any generalized tonic-clonic seizures occurred at night or from sleep? |
When was the patient's last MOTOR seizure (not including GTCs)? |
Recently, what is the frequency of MOTOR seizures (not including GTCs)? |
When was the patient's last nonmotor seizure (for example, absence seizure or seizures with impaired awareness only)? |
Recently, what is the frequency of nonmotor seizures? |
When was the patient's last epileptic spasm (single spasm or cluster)? |
Has the patient had status epilepticus requiring an emergency department visit in the past 12 mo? |
Think of patient's usual routines, how often in the past 2 wk have seizures significantly changed it? |
Think of patient's usual routine, how often in the past 2 wk have medication side effect changed it? |
Epilepsy type: (best guess, taking into consideration history and diagnostic findings) |
Is this child's epilepsy treatment resistant? |
Is this child's epilepsy new onset? (i.e., the first unprovoked seizure was less than 6 mo ago) |
What was the patient's age at first unprovoked seizure? |
Current epilepsy syndrome: |
Specific conditions associated with epilepsy: |
Has the patient ever had epilepsy surgery? (including devices) |
What kind of surgery? (can choose multiple) |
Is the epilepsy etiology known? |
Most recent brain imaging studies: |
Please list any other imaging findings here: |
Has genetic testing been conducted? |
What is the genetic or chromosomal abnormality? |
Is there a metabolic etiology? |
Is there an infectious etiology? |
Is there an autoimmune etiology? |
What imaging studies have been performed? |
Additional imaging study notes: |
What were the results of the patient's EEG? |
Does the patient have a developmental delay? (based on clinical impression/history) |
Psychiatric/behavioral/cognitive Does the patient have any of the following comorbidities? (select all that apply) |
Neurologic/heme Does the patient have any of the following comorbidities? (select all that apply) |
Technology dependent Does the patient have any of the following comorbidities? (select all that apply) |