VA Seizure Type and Frequency Rating for Complex Partial Seizures

 

Criteria for completion: history of complex partial seizures with altered consciousness

 

Parameters:

(1) total number of seizures since the last visit or other interval

(2) occurrence of the seizures in a cluster

(3) total number of seizures

(4) seizure frequency

(5) presence of aura (aura allows for avoidance of harm)

(6) precipitating factors (lack of sleep, alcohol, illness, other)

(7) subtherapeutic drug levels during period

(8) low therapeutic range drug levels during period

(9) presence of known cyclic or diurnal patterns

(10) loss of consciousness

 

Step 1: Determine if any of the seizures occurred in a cluster (>= 3 seizures within a 24 hour period). If so, divide the number of seizures in that cluster in half.

 

Step 2: Determine points for the seizure frequency.

Frequency of Seizures	Points
>= 4 per month	50 + (10 * (N - 4))
3 per month	40
2 per month	30
1 per month	20
more than 1 in 3 months and less than 1 per month	15
less than or equal to 1 in 3 months	10

 

where:

• "More than 1 in 3 months and less than 1 per month" equates to 2 in 3 months.

 

Step 3: Adjust initial points for other factors.

 

Factors	Present	Absent
aura	0.80	1
precipitating factor	0.50	1
subtherapeutic drug level	0.30	1
low therapeutic drug range	0.80	1
cyclic or diurnal patterns	0.60	1
loss of consciousness	1	0.5

 

where:

• The 2 drug levels are mutually exclusive (only 1 drug factor applies).

 

adjusted score for complex partial seizures =

= (initial score) * (factor for aura) * (factor for precipitating cause) * (factor for drug level) * (factor for cyclic or diurnal patterns) * (factor for loss of consciousness)

 

Interpretation:

• The final score for a patient is a summation of the adjusted scores for each seizure type present (generalized tonic clonic, complex partial, simple partial).