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Seizure Severity Questionnaire (SSQ) V2.2 (Baseline and Follow-Up Versions)
V2.2 (Baseline and Follow-Up Versions) Copyright JA Cramer 2010. Permission for use should be sought from the author, Dr. Joyce Cramer,
Supplemental: Epilepsy
Short Description of Instrument
Background: The seizure severity questionnaire (SSQ) was first described by Cramer, Baker, and Jacoby in 2002 as a new scale to assess seizure severity as a treatment response. Aspects of the VA seizure frequency and severity rating, the National Hospital seizure severity scale, and the Liverpool Seizure Severity Scale were reviewed and the development of the SSQ ensued with item generation, determination of validity and reliability. Minimally important changes thresholds for the SSQ were more recently reported (Cramer, et al, 2014).
Description: The Liverpool Seizure Severity Scale (LSSS) and the Seizure Severity Questionnaire (SSQ) are recommended for the measurement of perception of seizure severity in adults with epilepsy.The SSQ is a copyrighted instrument designed to capture the patient's, and an observer's, reported outcome (PRO) of the seizure experience including severity.
The baseline version consists of ten "main" questions with zero to three "branch questions" for each main. The scale asks for a description of the person's most common type of seizure from the past four weeks; and subsequently asks questions pertaining to the time before, during, and after the seizures as well as severity. Specifically addressed areas are: frequency and helpfulness of auras; severity and bothersomeness of ictal phenomenon; and questions about cognitive, emotional, and physical recovery. The most bothersome aspect is also questioned.
The follow-up version is meant to be given after a particular treatment initiation or change to determine differences in outcomes. There are 11 main questions in the follow-up version with zero to four "branching questions" and similar time frames as the baseline version.
Baseline scoring is done on a "1" through "7" scale with "1" being very mild or no bother and "7" indicating very severe or very bothersome. When assessing change in outcome, items are scored 1 through 7 in a range from very much improved to very much worse.
The SSQ is not designed for self-completion by the patient. The responses should be a composite agreement between the patient and observer, not the opinion of the clinician. While the SSQ can be used for all ages and all types of epilepsy. This scale is predominantly useful in evaluating response to treatment and the items reflect typical aspects of partial onset seizures that can be described by patients and observers.
Cramer JA, Baker GA, Jacoby A. Development of a new seizure severity questionnaire: initial reliability and validity testing. Epilepsy Res. 2002;48(3):187-197.
Cramer JA, de la Loge C, Brabant Y, Borghs S. Determining minimally important change thresholds for the Seizure Severity Questionnaire (SSQ). Epilepsy Behav. 2014;31:286-290.
Sancho J, Ivanez V, Molins A, et al. Changes in seizure severity and quality of life in patients with refractory partial epilepsy. Epilepsy Behav. 2010;19(3):409-413.


Document last updated June 2020