Clinical Presentation, Investigation and Management of Epilepsy Paediatric

Details

Title

Clinical Presentation, Investigation and Management of Epilepsy Paediatric

Type

Stage One

Module code

HPS215

Requirement

Compulsory

Module objective

By the end of this module the Clinical Scientist in HSST in collaboration with more senior Clinical Scientists and the clinician(s) responsible for the overall care of the patient, will be able to analyse, synthesise, evaluate and apply knowledge with respect to epilepsy and epileptic syndromes at paediatric age. They will be competent to identify the specialist assessments required to form a structured differential diagnosis and consistently demonstrate the attitudes and behaviours necessary for undertaking the role of a Consultant Clinical Scientist.

All Clinical Scientists in HSST working in a paediatric setting or who see children in their practice must be appropriately trained in child safeguarding.

Knowledge and understanding

By the end of this module the Clinical Scientist in HSST will analyse, synthesise, critically evaluate and apply their knowledge with respect to paediatric epilepsy, including:

• protecting paediatric patients and vulnerable adults from maltreatment, abuse, neglect, or exploitation (safeguarding);
• pathophysiology and prognosis of paediatric epilepsy, including paediatric epileptic syndromes;
• co-morbidities and medical and surgical treatments of epilepsy in paediatric patients, including how these may resemble or differ from epilepsy in adults;
• relevant national and local guidelines, pathways and protocols, recognising their benefits and limitations;
• concepts of disability, common causes of disability and the impact of disability for the child and family;
• common causes and effects of seizures in newborns and children;
• epileptic syndromes;
• principles of initial and continuing anticonvulsant therapy in babies and children;
• the long-term implications of epilepsy and the links between epilepsy and behaviour problems;
• the implications for families with patients of paediatric age with neurological and neurodisabling conditions;
• the long-term implications of epilepsy, including different epilepsy syndromes and the risk of learning difficulties, accident, or sudden death;
• support services for families;
• role of the paediatrician, community paediatrician and epilepsy nurse specialist;
• commissioning of paediatric epilepsy surgery services;
• psychosocial aspects of epilepsy;
• transition and transfer of paediatric patients to adult services, including the:
  • process of transition
  • needs of paediatric patients with epilepsy and their attitudes to their need for care
  • need to provide a seamless transfer of care from the paediatric to adult services for those with long-standing epilepsy
  • needs of learning disabled young people during transition and transfer into adult services.

Clinical scientific research topics:

• structural and functional neuroimaging;
• vascular biology;
• genetics of epilepsy;
• genomics.

Technical and clinical skills

By the end of this module the Clinical Scientist in HSST will demonstrate a critical understanding of current research and its application to paediatric epilepsy. They will be able to perform, and critically evaluate the following techniques, taking into account special circumstances, contraindications, confounding factors and risks, including:

• paediatric EEG;
• video telemetry;
• ambulatory monitoring;
• EEG monitoring on the intensive therapy unit.

They will be expected to analyse the results and present accurate, clear and concise documentation of patient data.ambulatory monitoring;

They will also be expected to contribute to the supervision, teaching and assessment of colleagues.

By the end of this module the Clinical Scientist in HSST will be expected to critically reflect and apply in practice an appropriate range of clinical and communication skills within their scope of practice, referring appropriately, and will:

Clinical examination:

• obtain informed consent within their scope of practice;
• take a relevant focused history (see Stage 1(ii), Advanced History Taking and Clinical Examination);
• in conjunction with the lead clinician select the neurophysiological investigations, taking into account special circumstances, contraindications, confounding factors and risks.

Diagnostic investigations and management, including:

• interpret and produce a supervised clinical report integrating the results from clinical neurophysiological investigations with the history, examination and other investigations;
• recognise and respond to the evolving information needs of paediatric patients and their parents or carers;
• explain results and clinical management plans simply and effectively to both clinicians and, where appropriate, patients;
• advise and communicate effectively with patients, relevant clinicians and the public, and other healthcare professionals working within the multidisciplinary team;
• adopt a multidisciplinary approach to the diagnosis and management of paediatric patients with epilepsy;
• reflect on the challenges of applying research to practice in relation to these areas of practice and suggest improvements, building on a critique of available evidence.