EPIPED Course: Treatment Strategies in Pediatric Epilepsies

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ILAE Curriculum Learning Objectives addressed by this course

• 1.1.1 Describe the major etiologies for epilepsy (i.e. structural, genetic, infectious, metabolic, immune, and neurodegenerative) (L1)
• 1.1.2 Describe the common structural etiologies
• 1.1.3 Describe the common genetic causes of epilepsy
• 1.1.4 Describe the common infectious causes of epilepsy, including geographical impacts (e.g. bacterial, fungal, viral, parasites) (L2)
• 1.1.5 Describe the common metabolic causes of epilepsy
• 1.1.6 Describe the common immune causes of epilepsy
• 1.1.7 Describe the common neurodegenerative causes of epilepsy
• 1.2.1 Decide on which patients to do genetic testing (L2)
• 1.3.1 Learn and recognize the seizure semiology and distinguish it from other non-epileptic manifestations
• 1.3.2 Extract semiology information from patient history
• 1.3.3 Extract semiology information from video recordings
• 1.3.4 Interpret semiological signs and symptoms allowing hypotheses on the localization of focal seizures
• 1.3.5 Interpret semiological signs and symptoms suggesting focal vs. generalized onset
• 1.3.6 Classify seizures according to the ILAE classification
• 1.4.1 Determine whom should receive EEGs, be familiar with sensitivity and specificity, and how to interpret the report in the clinical context (L1)
• 1.4.10 Recognize and describe ictal patterns (L2)
• 1.4.2 Demonstrate knowledge on how to conduct EEG recordings, including technical requirements (e.g. mounting electrodes, use filters, amplifiers, electrode arrays, etc.) (L2)
• 1.4.3 Demonstrate knowledge of montages - advantages and disadvantages (L2)
• 1.4.4 Interpret topographic (voltage) maps (L2)
• 1.4.5 Recognize the indications for the different types of provocation methods (L2)
• 1.4.6 Recognize the different types of EEG recordings and methodologies
• 1.4.7 Recognize and describe background activity and sleep patterns in all age groups (L2)
• 1.4.8 Recognize and distinguish artifacts and normal variants from abnormal EEG patterns, and take actions necessary for eliminating artifacts (L2)
• 1.4.9 Recognize and describe interictal abnormalities (L2)
• 1.5.1 Recognize the spectrum of MRI sequences optimized for epilepsy (L2)
• 1.5.2 Decide on whom to do structural neuroimaging (L1)
• 1.5.3 Decide when to conduct neuroimaging and repeat as needed (L2)
• 1.5.4 Decide when to conduct specialized neuroimaging and which type
• 1.6.1 Decide which patients should receive lab tests and which types of tests should be ordered (L1)
• 1.7.1 Accurately distinguish acute symptomatic seizures from epilepsy (L1)
• 1.7.2 Correctly distinguish between focal and generalized epilepsies and recognize epileptic encephalopathies (L1)
• 1.7.3 Correctly diagnose and classify focal epilepsies (L2)
• 1.7.4 Correctly diagnose and classify generalized epilepsies (L1)
• 1.7.5 Correctly diagnose and classify combined focal and generalized epilepsies including epileptic encephalopathy (L2)
• 1.8.1 Describe the epidemiology, psychiatric and experiential risk factors of PNES (L1)
• 1.8.2 Recognize the semiology of PNES and the use of video-EEG procedures and suggestion techniques in the diagnosis of suspected PNES (L2)
• 1.8.3 Describe formulation of diagnosis of PNES at different level as suggested by the ILAE PNES task force  (L2)
• 1.8.4 Recognize the typical semiology and risk profile associated with syncope (L1)
• 1.9 Identify patients at high risk of cardiac death: recognize semiology, risk factors and initial management of high risk of cardiac death (L1)
• 3.1.1 Identify the spectrum of action for antiepileptic drugs (L1)
• 3.1.2 Demonstrate knowledge of pharmacokinetics and pharmacodynamics (L1)
• 3.1.3 Demonstrate knowledge regarding the adverse effects of antiepileptic drugs (L1)
• 3.1.4 Demonstrate knowledge of appropriate monitoring of AES serum levels (L2)
• 3.1.5 Demonstrate knowledge about drug interactions (e.g. enzyme induction, etc.) for AED/AED and AED/concomitant medication
• 3.2.1 Recommend appropriate therapy according to seizure type (L1)
• 3.2.2 Recommend appropriate therapy according to epilepsy syndrome (L2)
• 3.2.3 Recommend individualized titrations of optimal dosing for patients including starting and discontinuing medication (L1)
• 3.2.4 Communicate information regarding the antiepileptic drug regimen (L1)
• 3.2.5 Recommend second- and third-line treatments as necessary (L2)
• 3.3.1 Define treatment strategies considering issues specific to pre-menopausal women (L2)
• 3.3.3 Define treatment strategies considering issues specific to the elderly (L2)
• 3.3.4 Define treatment strategies considering issues specific to sexual function and dysfunction (L2)
• 3.3.6 Define treatment strategies for infectious causes of epilepsy and seizures (L1)
• 3.3.7 Define treatment strategies for immune mediated causes of epilepsy and seizures (L2)
• 3.4.1 Demonstrate knowledge about the risks and opportunities associated with drug discontinuation and methodologies for individualized implementation (L2)
• 3.5.1 Identify patients who are drug resistant according to the current ILAE definition (L1)
• 4.1.1 Demonstrate working knowledge of indications for pre-surgical evaluation (L1)
• 4.2.1 Describe the importance of early surgical intervention regarding neuro-developmental, cognitive, behavioral and social integration aspects (L2)
• 4.4.1 Demonstrate working knowledge of etiologies amenable to surgical treatment and their prognoses in all age groups (L2)
• 5.1.1 Articulate the conditions or elements that constitute an emergency (L1)
• 5.1.2 Appropriately manage or advise regarding prolonged or sequential seizures (L1)
• 5.1.3 Appropriately manage or advise regarding injuries (L1)
• 5.1.4 Appropriately manage or advise regarding drug intoxication or adverse reactions (L1)
• 5.1.5 Appropriately manage or advise regarding psychiatric emergencies (L1)
• 5.2.1 Appropriately diagnose all types of convulsive status epilepticus (L1)
• 5.2.2 Appropriately diagnose all types of nonconvulsive status epilepticus including EEG interpretations
• 5.3.1 Appropriately manage all types of convulsive status epilepticus including EEG monitoring of treatment effect (L2)
• 5.3.2 Appropriately manage all types of nonconvulsive status epilepticus including EEG monitoring of treatment effect (L2)