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Click here to learn more about the basis for the profile and how it is used in clinical practice. If you are not my patient, only use this scale with permission of your epilepsy physician.

During the past four weeks, have you had any of the problems or side effects listed below?

Unsteadiness

Tiredness

Restlessness

Feelings of aggression

Nervousness and/or anxious

Headache

Hair loss

Problems with skin, i.e. acne, rash

Double or blurred vision

Upset stomach

Difficulty in concentrating

Trouble with mouth or gums

Shaky hands

Weight gain

Dizziness

Sleepiness

Depression

Memory Problems

Disturbed Sleep