Description of Event or Problem · 1
CLINIC NOTES DATED (B)(6) 2014 NOTE THAT SINCE THE PATIENT'S LAST VISIT ON (B)(6) 2013, THE PATIENT HAS EXPERIENCED AN INCREASE IN SEIZURES. IT WAS NOTED THAT THE PATIENT'S LAMICTAL WAS INCREASED AND THE PATIENT'S SEIZURES IMPROVED. IT WAS NOTED THAT THE PATIENT SUFFERED A SECOND INCREASE IN SEIZURES IN SEPTEMBER 2013. IT WAS NOTED THAT THE LAMICTAL WAS INCREASED A SECOND TIME; HOWEVER, LITTLE IMPROVEMENT WAS SEEN. IT WAS NOTED THAT THE PATIENT'S SEIZURES WENT FROM ONE SEIZURE A MONTH TO 4-5 SEIZURES A MONTH. IT WAS NOTED THAT THE SEIZURES TEND TO OCCUR TWO WEEKS PRIOR TO HER MENSES AND EITHER THE WEEK OF OR THE WEEK AFTER HER MENSES. THE SEIZURES OFTEN OCCUR IN PAIRS; SHE HAS A SEIZURE IN THE EVENING AROUND DINNER TIME AND ONE THE FOLLOWING MORNING SEVERAL HOURS AFTER AWAKENING. THE NOTES INDICATE THAT THE PATIENT'S SEIZURES HAVE CHANGED IN CHARACTER SINCE (B)(6) 2013. IT WAS NOTED THAT THE PATIENT NOW BECOMES STILL AND "FALLS LIKE A TREE, OFTEN ON HER FACE". IT WAS NOTED THAT IN THE PAST HER HABITUAL SEIZURES WERE DESCRIBED AS STARING AND LIP SMACKING. INITIALLY, THE INCREASE AND CHANGE IN SEIZURES WAS REPORTED ON MFR. REPORT # 1644487-2014-01499 AS THE INCREASE AND CHANGE IN SEIZURES WERE THOUGHT TO BE RELATED TO THE HIGH IMPEDANCE EVENT IN THIS REPORT. INFORMATION RECEIVED ON (B)(6) 2014 INDICATES THAT THE INCREASE AND CHANGE IN SEIZURES OCCURRED PRIOR TO THE HIGH IMPEDANCE EVENT. IT IS UNKNOWN IF THE INCREASE IN SEIZURES IS ABOVE THE PATIENT'S PRE-VNS BASELINE FREQUENCY. ATTEMPTS TO OBTAIN ADDITIONAL RELEVANT INFORMATION HAVE BEEN UNSUCCESSFUL TO DATE.