European Consensus Criteria A or B fulfilled
Age
Age at 1st seizure
Sex
Side involved clinically
Onset Symptom
Status epilepticus at onset
OnsetRe
Prodrome (time taken from onset to daily / recurrent seizures (months))
Influenza like symptoms at onset
Hypoxia or perinatal hospitalisation
Delayed developmental milestones
Neuroregression
Months to deficit
Generalised Seizures
Focal Seizures
Epilepsia partialis continua
Seizure Polymorphism Present ?
New or progressive focal deficit
CSF findings
EEG_Predicted _lateralisation
Ipsilateral Hemisphere Rythm
Contra-lateral hemisphere background rythm
Ipsialteral Hemisphere Inter-ictal Epileptiform Abnormality
Contra-leteral Hemisphere Inter-ictal Epileptiform Abnormality
EEG Background Supression
T2FLAIR signal pattern - fully evolved
Signal trend
Atrophy onset
Atrophy trend
Swelling pattern - fully evolved
Occip Sparing
Cerebellar Diaschisis
Date of Scan for lobar comparisons
Stage of Scan for lobar comparisons
Frontal Lobe Score
Parietal Lobe Score
Temporal Lobe Score
Occipital Lobe Score
Caudate Signal
Putamen Signal
Thalamus Signal
Brainstem Signal
Brainstem involvement
MedicalRxYN
Steroid Course received ?
Steroids Yes or No
Response to medical immune threapy
Radiological Stage at Presentation
Offered Surgery
Surgery Yes No
Type of surgery
IVIG Treatment received ?
Mycophenolate used as Steroid-sparing agent
Other immunosuppressants ?
Number of Anti-Epileptic Drugs at last follow up
Engel Class
Post-operative deficit worsening
Onset to peak seizure frequency
Stage at Presentation
Time from Onset to Presentation
Time from onset to atrophy
1st or 2nd half
Date of Symptom Onset
Total follow up
1st CMC visit
Last CMC visit
Date of worsening (stage 2)
Date of first abnormal scan
Date of Surgery
Disease onset to surgery
Hospital Arrival to Surgery
Onset to 1st scan
Onset to B1
Onset to B2
Onset to B3
Onset to B4
Total no of CT
Total no of MRI
Clinical Stage 1
Clinical Stage 2
Histology Summary
Grading of Cerebral Cortex
Grading of Neuron Loss
Grading of Astroglioisis
Grading of Microglial Activation
Grading of T Cell infiltration