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Posted by Kathy on February 15, 2000 at 17:11:41:

In Reply to: Adults with short term memory loss. Help! posted by Keith on February 14, 2000 at 22:05:33:


: Hi, I am an occupational therapy senior at the University of Oklahoma Health Sciences Center. I am researching on the topic of Short Term Memory Loss (STM) and Epilepsy. I have been living with epilepsy for 23 years now and have had dozens of seizures. My goal is to identify if a connection exists between the seizures and STM loss. I am collecting data for my project. If would like to assist me bye answering a nine question questionnaire, that takes about 5 minutes to complete, it would be greatly appreciated. There are two ways you can do this by answering the questions below and replying back or cut and paste the questionnaire and e-mailing it to:
: kparr@email.ouhsc.edu
: thank you again keith
: QUESTIONNAIRE
: Short Term Memory Loss and Epilepsy
: Please answer the following questions as they pertain to you. All findings will be used CONFIDENTIALLY as data in a research project.

: 1. _______ MALE ___x____ FEMALE

: 2. AGE:
: _______ 18-29
: ____x___ 30-39
: _______ 40-49
: _______ 50-59
: _______ 60-69
: _______ 70+

: 3. TYPE OF SEIZURES THAT YOU HAVE: ( please identify any that you have if known)
: _______ Not sure
: _______ Tonic-Clonic (Gran-mal)
: ___x____ Simple partial
: ___x___ Complex Partial
: _______ Absence (Petit-mal)
: _______ Acute repetitive ( 2 or more convulsions with in hours)
: _______ Status Epilepticus (recurrent convulsions lasting more than 20 minutes)

: 4. WHEN DID YOUR LAST SEIZURE OCCUR
: _2-13-00_________________________________________

: 5. FREQUENCY OF SEIZURES
: _______ Daily
: _______ Weekly
: depends___x____ Monthly
: _______ Yearly

: 6. ANTICONVULSION MEDICATIONS TAKEN:
: _______ Phenytoin (Dilantin)
: _______ Valporate (Depakene)
: _______ Phenobarbital
: _______ Primidone (Mysoline)
: _______ Zorantin
: _______ Clonazepam (Klonopin
: _______ Carbamazrpine (Tegretol, Carbatrol)
: _______ Gabapentin (Neurontin)
: _______ Lamotigine (Lamictal)
: _______ Topiramate (Topamax)
: _______ Not controlled by medication
: _______ Not sure of the name

: Other_ I do alternative medicne and no longer take any toxic meds they did more damage than ever good! ________________________________________________________

: 7. DO YOU EXPERIENCE SHORT TERM MEMORY LOSS?
: ____x___ YES
: _______ NO

: 8. IF YES, WHAT PART OF YOUR DAILY ACTIVITIES IS EFFECTED BY SHORT TERM MEMORY LOSS? (Please check all that apply)
: _______ Cooking
: _______ Caring for child/parent
: _______ Cleaning
: _______ Medication routine
: _______ School
: _______ Shopping
: _______ Work
: _______ Money management
: _______ Hygiene (showering /oral)
: _______ Driving
: _______ Leisure activities
: ___x____ Keeping appointments
:

Other- I lost 80% of my Verbal short term memory in a Worhtless Left front temprol lebectomy in 1993

_________________________________________________________

: 9. PLEASE DESCRIBE HOW SHORT TERM MEMORY LOSS IS EFFECTING YOU.

: It effects me negetivley and I wish I hadn't taken it for granted as I did only to have lost the majority of it. I kick myself daily for it!



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