DVBCWEN3 ;ALB/RLC EPILEPSY AND NARCOLEPSY WKS TEXT - 1 ; 6 MARCH 1997
;;2.7;AMIE;**170**;Apr 10, 1995;Build 1
;
;
TXT ;
;;A. Review of Medical Records:
;;
;;
;;B. Medical History (Subjective Complaints):
;;
;; Comment on:
;;
;; 1. State date of onset and describe circumstances and initial
;; manifestations.
;; 2. State course since onset.
;; 3. Current treatment, response, side effects.
;; 4. State whether continuous medication is necessary for the control of
;; epilepsy.
;; 5. History of related hospitalizations or surgery, dates and location, if
;; known, reason or type of surgery.
;; 6. History of CNS trauma - include date, location, and type of trauma.
;; 7. History of neoplasm:
;;
;; a. Date of diagnosis, exact diagnosis, location.
;; b. Benign or malignant.
;; c. Types of treatment and dates.
;; d. Last date of treatment.
;; e. State whether treatment has been completed.
;;
;; 8. Date of last seizure.
;; 9. Basis of diagnosis.
;; 10. Report frequency of episodes of narcolepsy, if any, during the past
;; 12-month period.
;; 11. State types of seizures experienced during the past 12-month period
;; and the frequency of each type.
;; 12. If there are psychomotor seizures, state which of the following are
;; characteristic of the seizures (name all that apply): automatic
;; states; generalized convulsions with unconsciousness; episodes of
;; random motor movements, episodes of hallucinations; episodes of
;; perceptual illusions; episodes of abnormalities of thinking, memory,
;; or mood; episodes of autonomic disturbances.
;; 13. State the method of determining the frequency of seizures.
;; 14. If possible, record the actual number and type(s) of seizures in each
;; calendar month during the past 12-month period. If the veteran keeps
;; a seizure diary, record dates of seizures.
;; 15. Indicate whether there are symptoms suggesting the presence of, or if
;; there is a history of, an organic brain syndrome or other mental
;; disorder that may be related to epilepsy. If so, describe.
;; 16. State precipitating or aggravating factors for seizures.
;; 17. State whether seizures are associated with post-ictal confusion.
;; 18. State whether seizures have increased or decreased in frequency during
;; the past 12-month period.
;;
;;C. Physical Examination (Objective Findings):
;;
;; 1. Order a psychiatric examination if there are indications of a
;; mental disorder associated with the seizure disorder.
;; 2. Report any significant physical findings associated with the disorder
;; or its treatment.
;;
;;D. Diagnostic and Clinical Tests:
;;
;; 1. EEG, CT scan, MRI as indicated.
;; 2. Include results of all diagnostic and clinical tests conducted
;; in the examination report.
;;
;;E. Diagnosis:
;;
;; 1. If the diagnosis is NOT established or is questioned, schedule
;; any necessary special studies, including admission for a
;; period of examination and observation, as appropriate to
;; provide a definitive diagnosis.
;; 2. Indicate the etiology, if known, and indicate whether a diagnosis of
;; epilepsy is confirmed and there is a history of seizures.
;; 3. For each diagnosis, state effects of the condition on occupational
;; functioning and daily activities.
;;
;;
;;Signature: Date:
;;END
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCWEN3 3731 printed Dec 13, 2024@01:50:54 Page 2
DVBCWEN3 ;ALB/RLC EPILEPSY AND NARCOLEPSY WKS TEXT - 1 ; 6 MARCH 1997
+1 ;;2.7;AMIE;**170**;Apr 10, 1995;Build 1
+2 ;
+3 ;
TXT ;
+1 ;;A. Review of Medical Records:
+2 ;;
+3 ;;
+4 ;;B. Medical History (Subjective Complaints):
+5 ;;
+6 ;; Comment on:
+7 ;;
+8 ;; 1. State date of onset and describe circumstances and initial
+9 ;; manifestations.
+10 ;; 2. State course since onset.
+11 ;; 3. Current treatment, response, side effects.
+12 ;; 4. State whether continuous medication is necessary for the control of
+13 ;; epilepsy.
+14 ;; 5. History of related hospitalizations or surgery, dates and location, if
+15 ;; known, reason or type of surgery.
+16 ;; 6. History of CNS trauma - include date, location, and type of trauma.
+17 ;; 7. History of neoplasm:
+18 ;;
+19 ;; a. Date of diagnosis, exact diagnosis, location.
+20 ;; b. Benign or malignant.
+21 ;; c. Types of treatment and dates.
+22 ;; d. Last date of treatment.
+23 ;; e. State whether treatment has been completed.
+24 ;;
+25 ;; 8. Date of last seizure.
+26 ;; 9. Basis of diagnosis.
+27 ;; 10. Report frequency of episodes of narcolepsy, if any, during the past
+28 ;; 12-month period.
+29 ;; 11. State types of seizures experienced during the past 12-month period
+30 ;; and the frequency of each type.
+31 ;; 12. If there are psychomotor seizures, state which of the following are
+32 ;; characteristic of the seizures (name all that apply): automatic
+33 ;; states; generalized convulsions with unconsciousness; episodes of
+34 ;; random motor movements, episodes of hallucinations; episodes of
+35 ;; perceptual illusions; episodes of abnormalities of thinking, memory,
+36 ;; or mood; episodes of autonomic disturbances.
+37 ;; 13. State the method of determining the frequency of seizures.
+38 ;; 14. If possible, record the actual number and type(s) of seizures in each
+39 ;; calendar month during the past 12-month period. If the veteran keeps
+40 ;; a seizure diary, record dates of seizures.
+41 ;; 15. Indicate whether there are symptoms suggesting the presence of, or if
+42 ;; there is a history of, an organic brain syndrome or other mental
+43 ;; disorder that may be related to epilepsy. If so, describe.
+44 ;; 16. State precipitating or aggravating factors for seizures.
+45 ;; 17. State whether seizures are associated with post-ictal confusion.
+46 ;; 18. State whether seizures have increased or decreased in frequency during
+47 ;; the past 12-month period.
+48 ;;
+49 ;;C. Physical Examination (Objective Findings):
+50 ;;
+51 ;; 1. Order a psychiatric examination if there are indications of a
+52 ;; mental disorder associated with the seizure disorder.
+53 ;; 2. Report any significant physical findings associated with the disorder
+54 ;; or its treatment.
+55 ;;
+56 ;;D. Diagnostic and Clinical Tests:
+57 ;;
+58 ;; 1. EEG, CT scan, MRI as indicated.
+59 ;; 2. Include results of all diagnostic and clinical tests conducted
+60 ;; in the examination report.
+61 ;;
+62 ;;E. Diagnosis:
+63 ;;
+64 ;; 1. If the diagnosis is NOT established or is questioned, schedule
+65 ;; any necessary special studies, including admission for a
+66 ;; period of examination and observation, as appropriate to
+67 ;; provide a definitive diagnosis.
+68 ;; 2. Indicate the etiology, if known, and indicate whether a diagnosis of
+69 ;; epilepsy is confirmed and there is a history of seizures.
+70 ;; 3. For each diagnosis, state effects of the condition on occupational
+71 ;; functioning and daily activities.
+72 ;;
+73 ;;
+74 ;;Signature: Date:
+75 ;;END
