CLINICAL PROTOCOL FOR A PATIENT HAVING A SEIZURE

             

PURPOSE:

To classify seizure type (partial, generalized, hysterical) by documenting
the seizure pattern.

1.   Observe

     a.   Onset - focal or symmetric

     b.   Eyes and head and pupil size

     c.   Extremities - tonic or clonic

     d.   Speech arrest

     e.   Automatisms

     f.   Incontinence

2.   Test

     a.   Mental status

          i.   Memory - nursery rhyme:  1, 2, buckle my shoe . . .

               show an object

          ii.  Comprehension - 1, 2, and 3 step commands

          iii. Orientation - ask name, place and date

     b.   Motor

          i.   Tone - passively move limbs

          ii.  Symmetry - ask patient to extend both arms

          iii. Control - drop patient's arm on his face

     c.   Sensory - test withdrawal to pain

     d.   Reflexes - biceps, knee and plantar