Curriculum for Project ECHO: Epilepsy in Children and Youth 

Number Topic Proposed title Learning objectives
1 Seizure Introduction: General definitions, Classification of seizures, epileptic seizures classification

 

“Seizure and epilepsy: Pearls for non-neurologist” · To review definitions and classification of seizures and epilepsy (provoked and unprovoked seizures, ILAE classifications , epilepsy definition)

· Relevant clinical epilepsy pearls for non neurologist

2 Seizure semiology:  focal and generalized non-motor seizures The “staring child” ·  Identify and learn the key clinical features that help to differentiate seizure types that manifest with non-motor semiology

·  Identify focal and generalized paediatric epilepsy syndromes that manifest predominantly with non-motor seizure semiology

3 Seizure semiology: Focal and generalized motor seizures “My child is shaking all over” · Identify, define and differentiate key features of focal and generalized onset seizure types with predominantly motor semiology (Tonic, clonic, hypermotor)

· Identify paediatric epilepsy syndromes presenting with predominant motor seizure semiology

4 Seizure semiology: Infantile spasms, epileptic spasms

 

“The jerky baby” · Identify, define key clinical features that helps to differentiate infantile spasm from other seizure types

· Identify, and differentiate paediatric epilepsy syndromes that manifest predominantly with  infantile and epileptic spams and their mimics

5 Testing: Epilepsy diagnosis and ancillary testing: EEG and Neuroimaging “Is it epilepsy?” What is the diagnostic work-up after the first seizures? ·Identify the clinical features that make the diagnosis of epilepsy in a child

· Review of febrile seizures

· Identify the specific clinical indications for paediatric EEG, neuroimaging and other tests in a child with epileptic seizures

· Understand how tests help to support the diagnosis of epilepsy

·  Recognize “key information” in the EEG and neuroimaging reports pertinent to children with seizures/epilepsy

6 Seizure mimics /Differential diagnosis “If it’s not epilepsy then what is it?” Differentiating epileptic and non-epileptic events

 

·  Identify clinical features and the appropriate diagnostic and treatment plan for children with febrile seizures, syncope, psychogenic non epileptic seizures (PNES) and other potential seizure mimics
7 Seizure safety DANGER: EPILEPSY Precautions to take in activities and resources available for support · Understand seizure safety in regards to water (swimming, baths), sports, physical activity , cooking, fire

· Review current laws, regulations and  guidelines  regarding driving in epilepsy

· Identify resources in the community available for families living with epilepsy

8 Starting the first AED trial Which Drug Do I choose? “The art of managing epilepsy”: How to choose the right anti-seizure medication · Understand the rationale of choosing the first antiepileptic drug for various seizure types in paediatrics

· Understand the importance of counselling families when an AED is started (dosing titrations, duration of the treatment, cost, formulations, ODB and drug  coverage)

9 AED side effects “ Know your weapons” What are the common side-effects of anti-seizure medications ·Define and identify the most common side effects of AEDs

· Understand the rationale for choosing AEDs based on side effect profile

·Identify chronic side effects and gender related differences when choosing AEDs

10 Common co-morbidities The seizures are controlled, but the quality of life is terrible: comorbidities in epilepsy? · Define and identify the most common comorbidities in epilepsy: mental health, cognition, cerebral palsy, autism

·Learn how to screen for comorbidities in epilepsy

· Learn the most appropriate approach when a comorbidity in epilepsy is identified

11 School supports Why is the school performance getting wore? School challenges in children with epilepsy ·  Epilepsy (stigma, bullying, learning disabilities, first aid seizure plan, school refusal)

· Learn about the resources available to help children with epilepsy in the school setting

12 Seizure emergency and status epilepticus (SE) “Seizure, seizure!!!!! Call 911”: What is a seizure/epilepsy emergency? ·Identify, learn and define the different types of status epilepticus (SE)

· Identify the most common causes, risks and complications associated with SE

· Identify and learn the appropriate approach to manage a child with prolonged seizures/SE outside the hospital: rescue plans, when to call the ambulance

·Identify and learn the appropriate steps on how to approach and manage a child with prolonged seizures/SE in the community emergency departments

13 Diagnosing drug resistant epilepsy Nothing works. What next? “When medications fail to control seizures: what options are there?”

 

 

· Identify, learn and define the concept of drug resistant epilepsy (DRE) and when to refer to a paediatric epilepsy program , referral pathways available in Ontario

· Pearls on non-pharmacological therapies: surgery, Ketogenic Diet, VNS (definitions and indications)

· Understand the importance to counsel regarding DRE

· Review the importance of  counseling about Sudden Unexpected Death in Epilepsy (SUDEP)

14 Cannabidiol, cannabinoids and alternatives “What about something ’natural’?”  – CBD treatment for seizures in children · Identify and learn the current indications, drug-drug interactions, side effects and practical facts regarding the use of cannabinoids in children with epilepsy
15 Transition to Adult care “Crossing the scary bridge from paediatric to adult epilepsy care” · Understand and learn the definition of Health Care Transition

·Learn and identify the current guidelines for transition to adult care of teenagers with epilepsy

This Group Learning program meets the certification criteria of the College of Family Physicians of Canada and has been certified by Continuing Professional Development, Faculty of Medicine, University of Toronto for up for up to 1.0 Mainpro+ credits.

This event is an Accredited Group Learning Activity (Section 1) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada, approved by Continuing Professional Development, Faculty of Medicine, University of Toronto. You may claim a maximum of 1.0 hours.