EPIPED Course: Treatment strategies in pediatric epilepsies

One of the main missions of the European Reference Network ERN EpiCARE, in close collaboration with the International League Against Epilepsy and the Paediatric Neurology Societies, is training and education. Complex epilepsies, particularly of childhood-onset, are those requiring multidisciplinary management through a care pathway or for associated comorbidities. Rare epilepsies with unknown etiology require a specific clinical and consequent diagnostic recognition utilizing a multidisciplinary approach.

The correct and timely diagnosis of rare forms of epilepsy is crucial for a tailored, successful treatment. During the last decade, the development of several new antiepileptic drugs and pre-surgical evaluation approaches have offered the chance for better care to an increasing number of children and adolescents with epilepsy. As an unavoidable result, best treatment choices become more and more complex, requiring a high level of expertise.

The aim of the 3-year cycle EPIPED-Treatment is to reduce the geographical and knowledge gap by providing neurologists and child neurologists involved in epilepsy care the opportunity for a regular update on best treatment practices. The concept of EPIPED is based on a 3-year cycle of independent annual training courses, developed specifically for child neurologists, physicians and epilepsy nurses caring for patients with epilepsy.

A limited number of plenary interactive sessions cover different aspects of treatment strategies in children with all types of epilepsies, particularly the rare and complex ones. Topics treated are related to pharmacology, pharmacodynamics, pharmacokinetics, genetics, analysis of AED trials, design of clinical trials, pre-surgical evaluation, optimal choice of AEDs, review of existing guidelines (ILAE, NICE, other), data on ketogenic diet, neurostimulation, indications for resective and palliative surgery, pharmacological treatments other than with AEDs, update on the development of targeted therapies. 

An important number of interactive modules allow participants, limited to 10-15 per group, to discuss with experts regarding the best clinical practices and therapeutic strategies. Participants, limited to 40-45, are offered the opportunity to also bring their own clinical cases for discussion of optimal treatment approaches. This educational activity is addressing the corresponding learning objectives of the ILAE curriculum.

Seventy neurologists and neuro-pediatricians from several countries attended all or part of the first 3-year cycle, held in Girona, Spain (2017-2019). Girona proved to be an excellent hosting city facilitating interaction and networking. At the end of the daily sessions, participants had time to enjoy the city and discover some of the varied local gastronomic proposals. The organization of EPIPED is also designed to facilitate networking, because we are convinced that it is only through collaborative working and sharing that an increased number of individuals with treatment-refractory epilepsy will have the cause of their epilepsy appropriately diagnosed and treated. The success of the first 3-year cycle and the numerous requests from those that already participated, easily convinced us to renew the experience and to organize a second 3-year cycle (2021-2023) of intensive training and interaction.
 
Alexis Arzimanoglou and Jaume Campistol
Course Directors

FACULTY :
Javier APARICIO (Spain), Thais ARMANGUE SALVADOR (Spain), Stéphane AUVIN (France), Fabrice BARTOLOMEI (France), Ingmar BLUMCKE (Germany), Kees BRAUN (The Netherlands), Mar CARRENO (Spain), Helen CROSS (UK), Georg DORFMULLER (France), Natàlia Egea CASTILLO (Spain), Carmen FONS (Spain), Giuseppe GOBBI (Italy), Hans HOLTHAUSEN (Germany), Philippe KAHANE (France), Lieven LAGAE (Belgium), Cécilie LANDMARK (Norway), Agathe LAURENT (France), Gaetan LESCA (France), Loreto LLANOS (Chile), Anna LOPEZ (Spain), Rima NABBOUT (France), Karine OSTROWSKY-COSTE (France), Emilio PERRUCA (Italy), Ronit PRESSLER (UK), Georgia RAMANTANI (Switzerland), Alia RAMIREZ (Spain), Rodrigo ROCAMORA (Spain), Jordi RUMIA (Spain), Nicola SPECCHIO (Italy), Federico VIGEVANO (Italy)