ILAE Curriculum
This competency-based curriculum addresses three different levels of professional expertise: 1) Entry, 2) Proficiency, 3) Advanced proficiency.
Domains:
Competencies:
Learning Objectives:
- 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 (e.g. hippocampal sclerosis, tumors, malformations, vascular lesions, traumatic brain injury, etc.) (L2)
- 1.1.3 Describe the common genetic causes of epilepsy (e.g. monogenic or polygenic inheritance, common germline or somatic mutations) (L2)
- 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 (e.g. inborn errors of metabolism, glucose transport defect, pyridoxine dependent seizures, mitochondrial pathologies) (L2)
- 1.1.6 Describe the common immune causes of epilepsy (e.g. Rasmussen encephalitis, LGI1 antibodies, NMDA antibodies, etc.) (L2)
- 1.1.7 Describe the common neurodegenerative causes of epilepsy (e.g. Alzheimer's disease, Down syndrome, Progressive Myoclonic Epilepsies) (L2)
Learning Objectives:
- 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
Learning Objectives:
- 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)
- 1.4.2 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 (e.g. invasive, scalp, stereo, video EEG) (L2)
- 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)
- 1.4.10 Recognize and describe ictal patterns (L2)
- 1.4.11 Recognize and describe ictal and interictal patterns with intracranial recordings (L3)
- 1.4.12 Demonstrate working knowledge of electromagnetic source imaging (L3)
Learning Objectives:
- 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 (e.g. functional, metabolic, post-processing, etc.) (L2)
- 1.5.5 Interpret and apply the results of specialized neuroimaging accurately in the clinical context (L3)
Learning Objectives:
- 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)
Learning Objectives:
- 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)
Competencies:
Learning Objectives:
- 2.3.1 Communicate to patients and families as appropriate (L1)
- 2.3.2 Educate patients and family about the disease specifics (L2) (e.g. prognosis, self-limiting, risk factors, etc.)
- 2.3.3 Educate caregivers about the clinical condition and its management (L2)
- 2.3.4 Educate workplace or school stakeholders concerning the patient's needs (L3)
- 2.3.5 Provide information to patients regarding potential adverse effects of antiepileptic drugs (L1)
- 2.3.6 Counsel patients and family regarding the risks and benefits of epilepsy surgery (L3)
Learning Objectives:
- 2.6.1 Provide guidance regarding contraception (L2)
- 2.6.2 Provide guidance regarding pregnancy, including teratogenicity of the various antiepileptic drugs (L2)
- 2.6.3 Provide guidance regarding post-partum and child care (L2)
- 2.6.4 Provide guidance regarding antiepileptic drugs and hormonal interactions (L2)
Learning Objectives:
- 2.10.1 Understand and address the culturally appropriate aspects and consequences of the diagnosis of PNES (L1)
- 2.10.2 Communicate information about the causes and consequences of PNES and the potential of psychological treatment (L2)
- 2.10.3 Counsel patients about tapering inappropriate antiepileptic drugs and the role of other medications (anxiolytics, antidepressants) in PNES (L2)
Competencies:
Learning Objectives:
- 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 (e.g. oral contraceptives, treatment of TB, HIV, etc.) (L2)
- 3.1.6 Demonstrate knowledge about treatment of psychiatric and cognitive comorbidities in children and adults (L3)
Learning Objectives:
- 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)
Learning Objectives:
- 3.3.1 Define treatment strategies considering issues specific to pre-menopausal women (L2)
- 3.3.2 Define treatment strategies considering issues specific to neonates and very young children (L3)
- 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)
- 3.3.5 Define treatment strategies considering genetic markers (L3)
- 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)
Competencies:
Learning Objectives:
- 4.3.1 Recommend and interpret video-EEG monitoring as appropriate) (L3) (including when it is indicated to repeat the monitoring
- 4.3.2 Recommend functional neuroimaging as appropriate (L3)
- 4.3.3 Recommend and interpret results of neuropsychological testing (L3)
- 4.3.4 Demonstrate working knowledge on planning implantation of intracranial electrodes (L3)
Learning Objectives:
- 4.6.1 Demonstrate knowledge about the risks and benefits associated with drug management (L3)
- 4.6.2 Demonstrate working knowledge of post-surgical neurological and psychiatric complications (L3)
- 4.6.3 Identify situations which require consideration of repeated surgery (L3)
- 4.6.4 Identify situations which require rehabilitation following surgery (L3)
Competencies:
Learning Objectives:
- 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) (e.g. psychosis, self-harm, agitation, suicidal ideation, etc.)
Competencies:
Learning Objectives:
- 6.1.1 Recognize psychiatric comorbidities, such as depression, anxiety, attention deficit and hyperactivity disorder, psychosis and autism spectrum disorders (L2)
- 6.1.2 Appropriately manage or advise regarding psychiatric comorbidities (L2)
- 6.1.3 Adjust anti-seizure treatment as required by psychiatric comorbidities (L2)
- 6.1.4 Demonstrate the ability to recognize and manage the special needs of persons with epilepsy (L3)
- 6.1.5 Manage cognitive changes in epilepsy and the cognitive effects of AEDs (L2)
Learning Objectives:
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