Module 6

Module 6 – Epilepsy

Moico Module 5 Alt
Seizure status, seizure types and EEG files
6.0 Seizure History (ANGSeizureTypes)
NoCodeQuestionResponse
6.0.0ANGEpilepsyEver2Has your child/ adult ever experienced any seizures?1 – Yes; 2 – No
6.0.1SeizureStatusWhat is their  current seizure status? Please report on your child/ adult’s current seizure status1 – Controlled without medication;
2 – Controlled with medication;
3 – Controlled with diet;
4 – Mostly controlled with occasional breakthroughs;
5 – Uncontrolled with medication;
6 – Uncontrolled without medication;
7 – Unknown 
6.0.2ANGSeizureBreakthroughWhat do you feel is the source of breakthrough seizures?1 – Illness/infection without fever;
2 – Illness/infection with fever;
3 – Co-medication/drug interaction;
4 – Tiredness/ fatigue;
5 – Emotions or overstimulation, e.g. stress, anxiety, or excitement;
6 – Hot weather, overheating or dehydration;
7 – Hormonal;
8 – Other;
9 – Unknown
6.0.3ANGSeizureAgeFirstWhat age was the first observed seizure activity? 
6.0.4ANGSeizureTypeWhat type of seizure was it?1 – Absence Seizures ,
2 -Myoclonic seizures,
3 – Atonic Seizures ,
4 –  Tonic, Clonic and Tonic-Clonic  Seizures
5 – Unknown/unaware of type
6.0.5ANGSeizureFirstTriggerWhat do you think triggered the seizure?1 – Illness/infection without fever;
2 – Illness/infection with fever;
3 – Co-medication/drug interaction;
4 – Tiredness/ fatigue;
5 – Emotions or overstimulation, e.g. stress, anxiety, or excitement;
6 – Hot weather, overheating or dehydration;
7 – Hormonal;
8 – Other;
9 – Unknown
6.0.6ANGSeizureMedicationWas medication given?Yes – please report in the medications and interventions module,
No –
6.0.7ANGSeizureHospitalisationWas hospitalisation required?Yes – please report in the medical history and hospitalisations module,
No –
6.0.8ANGSeizureMedicationOngoingWas ongoing medication prescribed at this stage?Yes – please report in the medications and interventions module,
No –
6.1 Has your child/ adult ever had any of the following seizure types? (ANGSeizureTypes)
NoCodeQuestionResponse
6.1.1ANGAtonicTypeYNUAtonic Seizures?1 – Yes;
2 – No;
3 – Unknown
6.1.2ANGAtonicOnsetAge of onset 
6.1.3ANGAtonicTypeStatusIs your child/ adult currently free from atonic seizures?1 – Yes;
2 – No
6.1.4ANGAtonicTypeRecurHas your child/ adult experienced freedom or recurrences of atonic seizures in the past?1 – Yes;
2 – No
6.1.5ANGAtonicTypeDescribe  
6.1.6ANGSeizureFrequencyAAtonicHow often do/did seizures occur?1- Daily;
2- Weekly;
3– Monthly;
4 – Yearly;
5 – Rarely (less than once a year)
6.1.7ANGSeizureFrequencyBAtonicHow many seizures do they typically have in this time frame?1– Less than 5;
2 – 5-10;
3 – 10-20;
4 – 20-50;
5 – More than 50
6.1.8ANGAtonicTriggerWhat events, if any, trigger their seizures?

1 – Illness/infection without fever;
2 – Illness/infection with fever;
3 – Co-medication/drug interaction;
4 – Tiredness/ fatigue;
5 – Emotions or overstimulation, e.g. stress, anxiety, or excitement;
6 – Hot weather, overheating or dehydration;
7 – Hormonal;
8 – Other;
9 – Unknown

6.1.9ANGAtonicTriggerOTHPlease specify 
6.1.10ANGAtonicMedicationEver been medicated for atonic seizures?Yes – please report in the medications and interventions module,
No –
6.1.11ANGAtonicHospitalisationEver been hospitalised for atonic seizures?Yes – please report in the medical history and hospitalisations module,
No –
6.1.12ANGAtonicCommentPlease comment on any other details about their atonic seizures (eg significant seizure events/ changes) 
6.1.13ANGTonicClonicTypeYNUTonic, Clonic or Tonic-Clonic seizures??1 – Yes;
2 – No;
3 – Unknown
6.1.14ANGTonicClonicTypeFGWas it focal or generalised?1 – Focal;
2 – Generalised;
3 – Unknown
6.1.16ANGTonicClonicTypeStatusHas your child/ adult experienced freedom or recurrences of Tonic, Clonic or Tonic-Clonic seizures in the past?1 – Yes;
2 – No
6.1.17ANGTonicClonicTypeTypeRecurPlease describe 
6.1.18ANGTonicClonicTypeDescribeHow often do/did seizures occur?1- Daily;
2- Weekly;
3– Monthly;
4 – Yearly;
5 – Rarely (less than once a year)
6.1.19SeizureFrequencyATonicClonicHow many seizures do they typically have in this time frame?1– Less than 5;
2 – 5-10;
3 – 10-20;
4– 20-50;
5 – More than 50
6.1.20SeizureFrequencyBTonicClonicWhat events, if any, trigger their seizures?1 – Illness/infection without fever;
2 – Illness/infection with fever;
3 – Co-medication/drug interaction;
4 – Tiredness/ fatigue;
5 – Emotions or overstimulation, e.g. stress, anxiety, or excitement;
6 – Hot weather, overheating or dehydration;
7 – Hormonal;
8 – Other;
9 – Unknown
6.1.21ANGTonicClonicTriggerPlease specify 
6.1.22ANGTonicClonicTriggerOTHEver been medicated for Tonic, Clonic or Tonic-Clonic seizures?Yes – please report in the medications and interventions module,
No –
6.1.23ANGTonicClonicMedicationEver been hospitalised for Tonic, Clonic or Tonic-Clonic seizures?Yes – please report in the medical history and hospitalisations module,
No–
6.1.24ANGTonicClonicHospitalisationPlease comment on any other details about their Tonic, Clonic or Tonic-Clonic seizures (eg significant seizure events/ changes) 
6.1.25ANGTonicClonicCommentPlease comment on any other details about their Tonic, Clonic or Tonic-Clonic seizures (eg significant seizure events/ changes) 
6.1.26ANGMyoclonicTypeYNUMyoclonic seizures?1 – Yes;
2 – No;
3 – Unknown
6.1.27ANGMyoclonicOnsetAge of onset 
6.1.28ANGMyoclonicTypeStatusIs your child/ adult currently free from Myoclonic seizures seizures?1 – Yes;
2 – No
6.1.29ANGMyoclonicTypeRecurHas your child/ adult experienced freedom or recurrences of Myoclonic seizures in the past?1 – Yes;
2 – No
6.1.30ANGMyoclonicTypeDescribePlease describe 
6.1.31SeizureFrequencyAMyoclonicHow often do/did seizures occur?1- Daily;
2- Weekly;
3– Monthly;
4 – Yearly;
5 – Rarely (less than once a year)
6.1.32SeizureFrequencyBMyoclonicHow many seizures do they typically have in this time frame?1 – Less than 5;
2 –  5-10;
3 – 10-20;
4 – 20-50;
5 – More than 50
6.1.33ANGMyoclonicTriggerWhat events, if any, trigger their seizures?1 – Illness/infection without fever;
2 – Illness/infection with fever;
3 – Co-medication/drug interaction;
4 – Tiredness/ fatigue;
5 – Emotions or overstimulation, e.g. stress, anxiety, or excitement;
6 – Hot weather, overheating or dehydration;
7 – Hormonal;
8 – Other;
9 – Unknown
6.1.34ANGMyoclonicTriggerOTHPlease specify 
6.1.35ANGMyoclonicMedicationEver been medicated for Myoclonic seizures?Yes – please report in the medications and interventions module,
No –
6.1.36ANGMyoclonicHospitalisationEver been hospitalised for Myoclonic seizures?Yes – please report in the medical history and hospitalisations module,
No –
6.1.37ANGMyoclonicCommentPlease comment on any other details about their Myoclonic seizures (eg significant seizure events/ changes) 
6.1.38ANGClusterMotorTypeYNUCluster motor seizures?1 – Yes;
2 – No;
3 – Unknown
6.1.39ANGClusterMotorTypeOnsetAge of onset 
6.1.40ANGClusterMotorTypeStatusIs your child/ adult currently free from Cluster motor seizures?1 – Yes;
2 – No
6.1.41ANGClusterMotorTypeRecurHas your child/ adult experienced freedom or recurrences of Cluster motor seizures in the past?1 – Yes;
2 – No
6.1.42ANGClusterMotorTypeDescribePlease describe 
6.1.43SeizureFrequencyAClusterMotorHow often do/did seizures occur?1- Daily;
2- Weekly;
3– Monthly;
4 – Yearly;
5 – Rarely (less than once a year)
6.1.44SeizureFrequencyBClusterMotorHow many seizures do they typically have in this time frame?1– Less than 5; 
2 – 5-10; 
3 – 10-20; 
4– 20-50; 
5 – More than 50
6.1.45ClusterMotorTriggerWhat events, if any, trigger their seizures?1 – Illness/infection without fever; 
2 – Illness/infection with fever; 
3 – Co-medication/drug interaction; 
4 – Tiredness/ fatigue;
5 – Emotions or overstimulation, e.g. stress, anxiety, or excitement; 
6 – Hot weather, overheating or dehydration; 
7 – Hormonal; 
8 – Other; 
9 – Unknown
6.1.46ClusterMotorTriggerOTHPlease specify 
6.1.47ClusterMotorMedicationEver been medicated for Cluster motor seizures?Yes – please report in the medications and interventions module,
No
6.1.48ClusterMotorHospitalisationEver been hospitalised for Cluster motor seizures?Yes – please report in the medical history and hospitalisations module, 
No –
6.1.49ClusterMotorCommentPlease comment on any other details about their Cluster motor seizures (eg significant seizure events/ changes) 
6.1.50ANGAbsenceTypeYNUAbsence seizures?1 – Yes;
2 – No;
3 – Unknown
6.1.51ANGAbsenceTypeOnsetAge of onset 
6.1.52ANGAbsenceTypeStatusIs your child/ adult currently free from Absence seizures?1 – Yes;
2 – No
6.1.53ANGAbsenceTypeRecurHas your child/ adult experienced freedom or recurrences of Absence seizures in the past?1 – Yes;
2 – No
6.1.54ANGAbsenceTypeDescribePlease describe 
6.1.55SeizureFrequencyAAbsenceHow often do/did seizures occur?1- Daily; 
2- Weekly; 
3– Monthly; 
4 – Yearly; 
5 – Rarely (less than once a year)
6.1.56SeizureFrequencyBAbsenceHow many seizures do they typically have in this time frame?1– Less than 5; 
2 – 5-10; 
3 – 10-20; 
4– 20-50; 
5 – More than 50
6.1.57ANGAbsenceTriggerWhat events, if any, trigger their seizures?1 – Illness/infection without fever; 
2 – Illness/infection with fever; 
3 – Co-medication/drug interaction; 
4 – Tiredness/ fatigue;
5 – Emotions or overstimulation, e.g. stress, anxiety, or excitement; 
6 – Hot weather, overheating or dehydration; 
7 – Hormonal; 
8 – Other; 
9 – Unknown
6.1.58ANGAbsenceTriggerOTHPlease specify 
6.1.59ANGAbsenceMedicationEver been medicated for Absence seizures?Yes – please report in the medications and interventions module,
No–
6.1.60ANGAbsenceHospitalisationEver been hospitalised for Absence seizures?Yes – please report in the medical history and hospitalisations module,
No –
6.1.61ANGAbsenceCommentPlease comment on any other details about their Absence seizures (eg significant seizure events/ changes) 
6.1.62ANGClusterNonMotorTypeCluster non-motor seizures?1 – Yes;
2 – No;
3 – Unknown
6.1.63ANGClusterNonMotorTypeOnsetAge of onset 
6.1.64ANGClusterNonMotorTypeStatusIs your child/ adult currently free from Cluster non-motor seizures?1 – Yes;
2 – No
6.1.65ANGClusterNonMotorTypeRecurHas your child/ adult experienced freedom or recurrences of Cluster non-motor seizures in the past?1 – Yes;
2 – No
6.1.66ANGClusterNonMotorTypeDescribePlease describe 
6.1.67SeizureFreqAClusterNonMotorHow often do/did seizures occur?1- Daily;
2- Weekly;
3– Monthly;
4 – Yearly;
5 – Rarely (less than once a year)
6.1.68SeizureFreqBClusterNonMotorHow many seizures do they typically have in this time frame?1– Less than 5; 
2 – 5-10; 
3 – 10-20; 
4– 20-50; 
5 – More than 50
6.1.69ClusterNonMotorTriggerWhat events, if any, trigger their seizures?1 – Illness/infection without fever; 
2 – Illness/infection with fever; 
3 – Co-medication/drug interaction; 
4 – Tiredness/ fatigue;
5 – Emotions or overstimulation, e.g. stress, anxiety, or excitement; 
6 – Hot weather, overheating or dehydration; 
7 – Hormonal; 
8 – Other; 
9 – Unknown
6.1.70ClusterNonMotorTriggerOTHPlease specify 
6.1.71ClusterNonMotorMedicationEver been medicated for Cluster non-motor seizures?Yes – please report in the medications and interventions module,
No –
6.1.72ClusterNonMotorHospitalisationEver been hospitalised for Cluster non-motor seizures?Yes – please report in the medical history and hospitalisations module,
No –
6.1.73ClusterNonMotorCommentPlease comment on any other details about their Cluster non-motor seizures (eg significant seizure events/ changes) 
6.1.74ANGSpasmTypeYNUEpileptic spasms?1 – Yes;
2 – No;
3 – Unknown
6.1.75ANGSpasmTypeOnsetAge of onset 
6.1.76ANGSpasmTypeStatusIs your child/ adult currently free from epileptic spasms?1 – Yes;
2 – No
6.1.77ANGSpasmTypeRecurHas your child/ adult experienced freedom or recurrences of epileptic spasms in the past?1 – Yes;
2 – No
6.1.78ANGSpasmTypeDescribePlease describe 
6.1.79SeizureFreqASpasmHow often do/did seizures occur?1- Daily;
2- Weekly;
3– Monthly;
4 – Yearly;
5 – Rarely (less than once a year)
6.1.80SeizureFreqBSpasmHow many seizures do they typically have in this time frame?1– Less than 5; 
2 – 5-10; 
3 – 10-20; 
4– 20-50; 
5 – More than 50
6.1.81SpasmTriggerWhat events, if any, trigger their seizures?1 – Illness/infection without fever; 
2 – Illness/infection with fever; 
3 – Co-medication/drug interaction; 
4 – Tiredness/ fatigue;
5 – Emotions or overstimulation, e.g. stress, anxiety, or excitement; 
6 – Hot weather, overheating or dehydration; 
7 – Hormonal; 
8 – Other; 
9 – Unknown
6.1.82SpasmTriggerOTHPlease specify 
6.1.83SpasmMedicationEver been medicated for epileptic spasms?Yes – please report in the medications and interventions module,
No –
6.1.84SpasmHospitalisationEver been hospitalised for epileptic spasms?Yes – please report in the medical history and hospitalisations module,
No –
6.1.85SpasmCommentPlease comment on any other details about their epileptic spasms? (eg significant seizure events/ changes) 
6.1.86ConvulsiveStatusTypeYNUConvulsive status epilepticus?1 – Yes;
2 – No;
3 – Unknown
6.1.87ANGConvulsiveStatusTypeFGWas it focal or generalised?1 – Focal;
2 – Generalised;
3 – Unknown
6.1.88ConvulsiveStatusTypeOnsetAge of onset 
6.1.89ANGConvulsiveStatusTypeStatusIs your child/ adult currently free from Convulsive status epilepticus??1 – Yes;
2 – No
6.1.90ANGConvulsiveStatusTypeRecurHas your child/ adult experienced freedom or recurrences of Convulsive status epilepticus in the past?1 – Yes;
2 – No
6.1.91ConvulsiveStatusTypeDescribePlease describe 
6.1.92SeizureFreqAConvulsiveStatusHow often do/did seizures occur?1- Daily; 
2- Weekly; 
3– Monthly; 
4 – Yearly; 
5 – Rarely (less than once a year)
6.1.93SeizureFreqBConvulsiveStatusHow many seizures do they typically have in this time frame?1– Less than 5; 
2 – 5-10; 
3 – 10-20; 
4– 20-50; 
5 – More than 50
6.1.94ConvulsiveTriggerWhat events, if any, trigger their seizures?1 – Illness/infection without fever; 
2 – Illness/infection with fever; 
3 – Co-medication/drug interaction; 
4 – Tiredness/ fatigue;
5 – Emotions or overstimulation, e.g. stress, anxiety, or excitement; 
6 – Hot weather, overheating or dehydration; 
7 – Hormonal; 
8 – Other; 
9 – Unknown
6.1.95ConvulsiveTriggerOTHPlease specify 
6.1.96ConvulsiveMedicationEver been medicated for Convulsive status epilepticus??Yes – please report in the medical history and hospitalisations module, 
No –
6.1.97ConvulsiveHospitalisationEver been hospitalised for Convulsive status epilepticus??Yes – please report in the medical history and hospitalisations module, 
No –
6.1.98ConvulsiveCommentPlease comment on any other details about their Convulsive status epilepticus? (eg significant seizure events/ changes) 
6.1.99NonConvulsiveStatusTypeYNUNon-convulsive status epilepticus?1 – Yes;
2 – No;
3 – Unknown
6.1.100NonConvulsiveStatusTypeOnsetAge of onset 
6.1.101ANGNonConvulsiveStatTypeStatusIs your child/ adult currently free from Non-convulsive status epilepticus?1 – Yes;
2 – No
6.1.102NonConvulsiveStatusTypeRecurHas your child/ adult experienced freedom or recurrences of Non-convulsive status epilepticus in the past?1 – Yes;
2 – No
6.1.103NonConvulsiveStatusDescribePlease describe 
6.1.104SeizureFreqANonConvulsiveStatHow often do/did seizures occur?1- Daily; 
2- Weekly; 
3– Monthly; 
4 – Yearly; 
5 – Rarely (less than once a year)
6.1.105SeizureFreqBNonConvulsiveStatHow many seizures do they typically have in this time frame?1– Less than 5; 
2 – 5-10; 
3 – 10-20; 
4– 20-50; 
5 – More than 50
6.1.106NonConvulsiveTriggerWhat events, if any, trigger their seizures?1 – Illness/infection without fever; 
2 – Illness/infection with fever; 
3 – Co-medication/drug interaction; 
4 – Tiredness/ fatigue;
5 – Emotions or overstimulation, e.g. stress, anxiety, or excitement; 
6 – Hot weather, overheating or dehydration; 
7 – Hormonal; 
8 – Other; 
9 – Unknown
6.1.107NonConvulsiveTriggerOTHPlease specify 
6.1.108NonConvulsiveStatMedicationEver been medicated for Non-convulsive status epilepticus?Yes – please report in the medical history and hospitalisations module, 
No –
6.1.109NonConvulsiveStatHospEver been hospitalised for Non-convulsive status epilepticus?Yes – please report in the medical history and hospitalisations module, 
No –
6.1.110NonConvulsiveStatCommentPlease comment on any other details about their Non-convulsive status epilepticus (eg significant seizure events/ changes) 
6.1.111UnknownTypeYNUUnknown/ unaware?1 – Yes;
2 – No;
3 – Unknown
6.1.112ANGUnknownTypeOnsetAge of onset 
6.1.113ANGUnknownTypeStatusIs your child/ adult currently free from unknown/ unaware?1 – Yes;
2 – No
6.1.114ANGUnknownTypeRecurHas your child/ adult experienced freedom or recurrences of unknown/ unaware in the past?1 – Yes;
2 – No
6.1.115ANGUnknownTypeDescribePlease describe 
6.1.116ANGSeizureFrequencyAUnknownHow often do/did seizures occur?1- Daily; 
2- Weekly; 
3– Monthly; 
4 – Yearly; 
5 – Rarely (less than once a year)
6.1.117ANGSeizureFrequencyBUnknownHow many seizures do they typically have in this time frame?1– Less than 5; 
2 – 5-10; 
3 – 10-20; 
4– 20-50; 
5 – More than 50
6.1.118ANGUnknownTriggerWhat events, if any, trigger their seizures?1 – Illness/infection without fever; 
2 – Illness/infection with fever; 
3 – Co-medication/drug interaction; 
4 – Tiredness/ fatigue;
5 – Emotions or overstimulation, e.g. stress, anxiety, or excitement; 
6 – Hot weather, overheating or dehydration; 
7 – Hormonal; 
8 – Other; 
9 – Unknown
6.1.119ANGUnknownTriggerOTHPlease specify 
6.1.120ANGUnknownMedicationEver been medicated for unknown/ unaware?Yes – please report in the medical history and hospitalisations module, 
No –
6.1.121ANGUnknownHospitalisationEver been hospitalised for unknown/ unawaye seizures?Yes – please report in the medical history and hospitalisations module, 
No –
6.1.122ANGUnknownCommentPlease comment on any other details about their unknown/ unaware seizures (eg significant seizure events/ changes) 
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