Project ECHO: Epilepsy in Adults

Topic* Learning Objectives
First Seizure and Diagnosis
  • 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
Generalized Versus Focal Epilepsies
  • 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
Drugs and Basic Management
  • 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
Driving and Safety
  • 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
Cannabidiol and Cannabinoids
  • 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
Basic Electroencephalography (EEG) Concepts
  • 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
Selecting Candidates for Epilepsy Surgery
  • 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
Psychogenic Non-Epileptic Seizures (PNES)
  • 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
Pregnancy, Teratogenicity, and other issues pertaining to AED use
  • 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
Comorbidities
  • 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

This one-credit-per hour 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 to 1.5 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 1.5 hours.

*Some topics will be covered over the course of 2 sessions