First aide for a seizure
       Do not put anything in the patients mouth as it may lead to gagging, vomiting and aspiration.
       EFA video
https://www.epilepsy.com/learn/seizure-first-aid-and-safety/first-aid-seizures-stay-safe-side

​weekly medication box

      The decision to use a weekly medication box can at times be more important than deciding which medication to put in it. Without question the boxes make it easier to take medication on time, particularly if it has a built-in timer. Even for those patients who exhibit perfect compliance with their anticonvulsant regimen and never miss a dose the boxes can be very helpful. It is not uncommon to get a call from a patient's parent, spouse etc. immediately after a seizure has occurred when the patient is either unconscious or confused and not in a position to remember whether or not medication might have been missed. In this context it is invaluable to be able to look in the weekly medication box and know for certain whether there is an easy identifiable reason for the seizure. When it can be shown that medication has been missed then then obtaining emergency blood test for anticonvulsant levels usually not required.
       Coronavirus: in context of a new schedule for those working/quarantined at home making it easier to miss medication the weekly medication box is particularly important. 

medication reconciliation

     As defined by the JCAHO (Joint Commission on Accreditation of Healthcare Organizations) medication reconciliation is "the process of comparing a patient's medication orders to all of the medications that the patient has been taking. This reconciliation is done to avoid medication errors such as omissions, duplications, dosing errors, or drug interactions. It should be done at every transition of care in which new medications are ordered or existing orders are rewritten." 
       This is now required at every appointment and thus we need to see the original medication containers with the name, dose and directions for each medication.
       Please bring all active medication bottles to each visit.    
       Please bring as well all non-prescription vitamins and supplements 

video interviews during seizures

      Getting a reliable description of a seizure makes it much easier to make a precise paroxysmal episode/seizure/epilepsy diagnosis. It is helpful if witnesses write down immediately what they see while it is still fresh in their mind. In the past 20 years the gold standard has become capturing events on video. It never ceases to amaze us how resourceful patients and families can be. Some set up security cameras/nanny cams in their bedrooms and offices. Ideally if possible we ask family and other witnesses to perform as our staff does in the epilepsy monitoring unit and interact with the patient trying to document objectively varying levels of responsiveness and confusion. It is important to give directions and ask questions with very specific responses/answers even if the answer itself is given in the question (e.g. "John tell me your name"). In addition to testing the level of confusion and responsiveness it is also important to test the patient's ability to make new memories. To this end we suggest presenting three words at some point during the seizure which can be tested for later on. As the confusion starts to clear it is helpful to ask the patient to repeat a phrase until it can be repeated without error to demonstrate how long it takes a language disturbance to clear. In our monitor unit we typically use "they heard him speak on the radio last night" but any similar phrase will do. It is helpful to have a protocol written out and practiced ahead of time in that seizures so often occur unexpectedly when one is least prepared and acutely it can be difficult to remember to cover everything that needs to be covered.