Skip to main content
. 2022 Jan 11;9(1):16–29. doi: 10.1002/acn3.51485

Table 1.

Daily seizure questionnaire and admission questionnaire items.

A: Daily seizure questionnaire
Item Question Options
1. Do you think you had a seizure since the last time I asked you these questions? Yes/No
1a. If yes, how many? N/A
1b. What time do you think the seizure(s) occurred? N/A
For each seizure patient recalls, ask the following:
2. Were you able to respond to other people during your seizure? Yes/No
3. Could you speak during your seizure? Yes/No
4. Do you remember what happened during the actual seizure? Yes/No
5. Do you remember someone (me, nurse, other student) asking you questions during your seizure? Yes/No
6. Were you aware of what was going on around you during your seizure? Yes/No
7. Did you lose consciousness or black out? Yes/No
B: Admission questionnaire
Item Question Options
1. Are you able to respond to other people during your seizures? Always/Sometimes/Never
2. Are you able to speak during your seizures? Always/Sometimes/Never
3. Are you aware of what is going on around you during your seizures? Always/Sometimes/Never