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					Name                                                           CHI number

Seizure Classification Sheets
Seizure name                                                            Seizure type                        A
Describe any possible triggers to this type of seizure:



What time of day does this type tend to happen?


Describe any behavioural changes that occur in the lead up to the seizure (including
duration, e.g. days, hours):



Describe any warning (aura) prior to seizure:


Description (including USUAL duration of each part of seizure, eg 2-3 minutes and
colour change or change in breathing pattern throughout the seizure):




Describe any action that requires to be taken at this stage:




Describe usual recovery, including usual duration:




Describe action to be taken as they recover:




Completed by: Name: ............................... Job Title: ................................ Date: .................
Validated by: Name: ............................... Job Title: ................................ Date: .................
(Clinician)
This documentation has been produced by the West of Scotland & Tayside Epilepsy MCN (Dec ’08)              Page ..........
Guidance on completion & copies of all care planning documentation are available at www.epilepsytoolbox.scot.nhs.uk
Name                                                           CHI number

Seizure Classification Sheets
Seizure name                                                            Seizure type                        B
Describe any possible triggers to this type of seizure:



What time of day does this type tend to happen?


Describe any behavioural changes that occur in the lead up to the seizure (including
duration, e.g. days, hours):



Describe any warning (aura) prior to seizure:


Description (including USUAL duration of each part of seizure, eg 2-3 minutes and
colour change or change in breathing pattern throughout the seizure):




Describe any action that requires to be taken at this stage:




Describe usual recovery, including usual duration:




Describe action to be taken as they recover:




Completed by: Name: ............................... Job Title: ................................ Date: .................
Validated by: Name: ............................... Job Title: ................................ Date: .................
(Clinician)
This documentation has been produced by the West of Scotland & Tayside Epilepsy MCN (Dec ’08)              Page ..........
Guidance on completion & copies of all care planning documentation are available at www.epilepsytoolbox.scot.nhs.uk
Name                                                           CHI number

Seizure Classification Sheets
Seizure name                                                            Seizure type                        C
Describe any possible triggers to this type of seizure:



What time of day does this type tend to happen?


Describe any behavioural changes that occur in the lead up to the seizure (including
duration, e.g. days, hours):



Describe any warning (aura) prior to seizure:


Description (including USUAL duration of each part of seizure, eg 2-3 minutes and
colour change or change in breathing pattern throughout the seizure):




Describe any action that requires to be taken at this stage:




Describe usual recovery, including usual duration:




Describe action to be taken as they recover:




Completed by: Name: ............................... Job Title: ................................ Date: .................
Validated by: Name: ............................... Job Title: ................................ Date: .................
(Clinician)
This documentation has been produced by the West of Scotland & Tayside Epilepsy MCN (Dec ’08)              Page ..........
Guidance on completion & copies of all care planning documentation are available at www.epilepsytoolbox.scot.nhs.uk
Name                                                           CHI number

Seizure Classification Sheets
Seizure name                                                            Seizure type                        D
Describe any possible triggers to this type of seizure:



What time of day does this type tend to happen?


Describe any behavioural changes that occur in the lead up to the seizure (including
duration, e.g. days, hours):



Describe any warning (aura) prior to seizure:


Description (including USUAL duration of each part of seizure, eg 2-3 minutes and
colour change or change in breathing pattern throughout the seizure):




Describe any action that requires to be taken at this stage:




Describe usual recovery, including usual duration:




Describe action to be taken as they recover:




Completed by: Name: ............................... Job Title: ................................ Date: .................
Validated by: Name: ............................... Job Title: ................................ Date: .................
(Clinician)
This documentation has been produced by the West of Scotland & Tayside Epilepsy MCN (Dec ’08)              Page ..........
Guidance on completion & copies of all care planning documentation are available at www.epilepsytoolbox.scot.nhs.uk
Name                                                           CHI number

Seizure Classification Sheets
Seizure name                                                            Seizure type                        E
Describe any possible triggers to this type of seizure:



What time of day does this type tend to happen?


Describe any behavioural changes that occur in the lead up to the seizure (including
duration, e.g. days, hours):



Describe any warning (aura) prior to seizure:


Description (including USUAL duration of each part of seizure, eg 2-3 minutes and
colour change or change in breathing pattern throughout the seizure):




Describe any action that requires to be taken at this stage:




Describe usual recovery, including usual duration:




Describe action to be taken as they recover:




Completed by: Name: ............................... Job Title: ................................ Date: .................
Validated by: Name: ............................... Job Title: ................................ Date: .................
(Clinician)
This documentation has been produced by the West of Scotland & Tayside Epilepsy MCN (Dec ’08)              Page ..........
Guidance on completion & copies of all care planning documentation are available at www.epilepsytoolbox.scot.nhs.uk