provided by Dr. Bas Stunnenberg 
of Radboud University Medical Centre, Netherlands.
Attack diary
Periodic Paralyses (HypoPP, NormoPP, HyperPP and ATS)
Version 2: Oct 2015 Translated into English for the Periodic Paralysis Association
Author: Bas Stunnenberg, MD/ PhD-candidate, resident Neurology, Radboud University Medical Center Nijmegen, Netherlands
Instructions:
Example: You (a HypoPP patient) wake up in the morning (8 am) of Januari 1 2016 with an attacks of muscle weakness of the arms and legs. The evening before the attack you had a big meal of carbohydrates and went to the gym. The attack duration (of subjective muscle weakness) is 2 hours and you need assistance to get to the toilet and get dressed and you can not walk without assitance. During the attack you take 120 ml (mmol) of KCl.| Attack date | Attack duration (min) | Attack severity (see Attack severity) | Triggering factors | Attack Medication taken during attack | Muscles involved during the attacks (arms / legs/ face/ all) |
| 1-1-2016 | 120 | 4 | Carbohydrate-rich meal, (rest after) exercise | 120 ml KCl | Legs and arms |
Attack severity can be scored using the GBS-severity scale that was also used in the previous treatment studies on the group level (Tawil et al. Annals of Neurology, 2000).
Attack severity is scored on a 1-6 scale with: 1= no complaints, 2= mild complaints of muscle weakness but capable of performing daily tasks, 3= capable of walking without help of a walking stick, but not capable of performing daily tasks, 4= Only capable of walking with a walking stick or with support of another person, 5= Bound to bed or wheelchair due to the attack of weakness, 6= ER or ICU admission due to severe weakness paralysis of arms and legs.
For multiple attacks on one day use multiple lanes to record the attack characteristics.
Period (duration 1 month): from _____ till _____ .
