Adult Epilepsy Curriculum

Topic:

First Seizure and Diagnosis

Learning Objective:

• Differentiate seizures from syncope
• Identify, define, and accurately assess seizure types
• Differentiate between seizures and epilepsy
• Undertake the workup needed for a first seizure that can be undertaken by primary care providers
• Describe the treatment-decision making process for first seizure

Topic:

Generalized Versus Focal Epilepsies

Learning Objective:

• Distinguish the differences between focal and generalized epilepsies
• Clarify the differences between absence seizures and focal seizures
• Review the natural history, seizures types and treatment goals for Juvenile Myoclonic Epilepsy (JME) and how to best care for these patients
• Describe when to order appropriate neuroimaging protocols for patients with epilepsy

Topic:

Drugs and Basic Management

Learning Objective:

• Select appropriate medicine in accordance with patient needs and eligible patient drug benefits such as Ontario Drug Benefit Program and OHIP+
• Describe commonly used anti-seizure medications in terms of their use and side effect profiles and place of therapeutic drug monitoring
• Identify pros and cons of new vs. old anti-seizure medication
• Describe effective practices for acute or rescue management of seizures
• Recognize, utilize, and leverage the pathway for the chronic treatment of epilepsy

Topic:

Driving and Safety

Learning Objective:

• List the rules and regulations with regards to patient reporting to the Ministry of Transportation and describe the physician’s role with regards to driving and license reinstatement
• Describe considerations for work and workplace safety for people with epilepsy
• Identify and explain personal safety concerns (water safety, other outdoor activities)
• Review firearms safety for people with epilepsy

Topic:

Cannabidiol and Cannabinoids

Learning Objective:

• Identify the current evidence for the use of cannabinoids in epilepsy
• Describe the side effects of cannabinoids and their interactions with other drugs
• Describe the practical implications of cannabidol use in patients with epilepsy

Topic:

Basic Electroencephalography (EEG) Concepts

Learning Objective:

• Describe the role of EEG in the diagnosis and treatment of seizures and epilepsy
• Describe the scope and limitations of EEG in epilepsy management
• Interpret EEG reports in the context of epilepsy diagnosis and treatment

Topic:

Selecting Candidates for Epilepsy Surgery

Learning Objective:

• Summarize the reasons why epilepsy surgery is a treatment option
• Describe how to identify patients that may be surgical candidates
• Describe the appropriate referral pathway for surgical candidates

Topic:

Psychogenic Non-Epileptic Seizures (PNES)

Learning Objective:

• Distinguish between PNES and epileptic seizure
• Describe treatment options for patients with PNES
• Describe the rates of overlap between epileptic seizures and psychogenic non-epileptic events

Topic:

Pregnancy, Teratogenicity, and other issues pertaining to AED use

Learning Objective:

• Recognize special considerations for prescribing AEDs and reproduction
• Describe the rates of teratogenicity for various drugs
• Describe how AEDs impact bone health and how to manage bone health
• Recognize and describe caregiver safety concerns such as breastfeeding and caring for young children

Topic:

Comorbidities

Learning Objective:

• Identify the most common psychiatric comorbidities in adults with epilepsy and review referral and diagnosis pathways
• Describe the risk factors for Sudden Unexpected Death in Epilepsy (SUDEP), and how to manage at risk patients
• Identify roles and resources available through interprofessional team members, including local epilepsy agencies, to optimize quality of life and psychosocial support for adults with epilepsy