Back Module: S-N-S2

Paediatric Neurophysiology

Module information

Module details

Title
Paediatric Neurophysiology
Type
Specialist
Module code
S-N-S2
Credits
10
Phase
2
Requirement
Compulsory

Aim of this module

This module aims to provide trainees with the knowledge and skills to perform EEGs and adapt their practice to patients across a broad spectrum of ages, neurological conditions, developmental stages and levels of co-operation.

Work-based content

Training activities

# Learning outcome Training activity Type Action
# 1 Learning outcome 2,3 Training activities

Plan and prepare to conduct an EEG for:

  • Full term neonate (first 28 days of life)
  • Infant (up to one year)
  • Child under five
  • Child over five
 Type ETA Action View
# 2 Learning outcome 2,3 Training activities

Adapt and explain EEG procedures to a child and/or their parent/guardian to ensure co-operation with the diagnostic testing to include:

  • Full term neonate (first 28 days of life)
  • Infant (up to one year)
  • Child under five
  • Child over five
  • A child with complex needs e.g. learning difficulties, language barrier or autistic spectrum disorder
 Type ETA Action View
# 3 Learning outcome 2,3 Training activities

Prepare patients and perform an EEG to include:

  • Full term neonate (first 28 days of life)
  • Infant (up to one year)
  • Child under five
  • Child over five
  • A child with complex needs e.g. learning difficulties, language barrier or autistic spectrum disorder
 Type ETA Action View
# 4 Learning outcome 1,3,5 Training activities

Interpret and annotate EEGs, and produce a full factual report for a normal recording to include the following:

  • Full term neonate (first 28 days of life)
  • Infant (up to one year)
  • Child under five
  • Child over five
 Type ETA Action View
# 5 Learning outcome 1,3,5 Training activities

Interpret and annotate EEGs and produce a full factual report for abnormal recordings to include each of the following conditions:

  • Epilepsy syndromes
  • Acquired brain injuries
  • Infections
  • Non epileptic
 Type ETA Action View
# 6 Learning outcome 2,3 Training activities

Plan and prepare to conduct pre-term neonatal EEGs

 Type ETA Action View
# 7 Learning outcome 1,3,4 Training activities

Assist in performing pre-term neonatal EEGs

 Type ETA Action View
# 8 Learning outcome 1,3,5 Training activities

Draft full factual reports for pre-term neonatal EEGs

 Type ETA Action View
# 9 Learning outcome 1,2,3,4 Training activities

Select and perform hyperventilation and photic stimulation activation procedures to include:

  • Children under five
  • Children over five
 Type ETA Action View
# 10 Learning outcome 3,6 Training activities

Present a patient pathway to the multidisciplinary team for a patient you have seen with one of the following conditions:

  • Epilepsy syndromes
  • Acquired brain injuries
  • Infections
  • Non epileptic
 Type DTA Action View

Assessments

Complete 2 Case-Based Discussions

Complete 2 DOPS or OCEs

Direct Observation of Practical Skills Titles

  • Plan and prepare for a paediatric EEG.
  • Record a paediatric resting EEG.
  • Record a resting EEG with extra polygraphy (EMG,OEG) etc.
  • Measure a head according to a recognised system.
  • Apply electrodes to within 5mm accuracy.
  • Annotate a patient’s sleep state changes.

Observed Clinical Event Titles

  • Take a patient history.
  • Explain activation procedures to a child between five and ten years and obtain appropriate consent.
  • Explain the EEG procedure in a manner appropriate to the age of the child and any special needs they may have.
  • Provide appropriate and relevant sleep deprived EEG aftercare information to patients/parents/guardians.

Learning outcomes

# Learning outcome
1

Identify features of normal and abnormal neonatal and paediatric EEGs, including activation procedures.
2

Prepare patients and environments for testing, maintaining safety and patient dignity.
3

Demonstrate effective and compassionate communication skills with all stakeholders, including patients and the multidisciplinary team.
4

Perform neonatal and paediatric EEGs, including activation procedures in a range of conditions and ages, maintaining patient safety and ensuring patient experience.
5

Generate factual reports on a range of conditions and ages assessing, clinical priority and identifying cases requiring escalation.
6

Describe paediatric neurophysiology patient pathways.

Clinical experiences

Clinical experiences help you to develop insight into your practice and a greater understanding of your specialty's impact on patient care. Clinical experiences should be included in your training plan and you may be asked to help organise your experiences. Reflections and observations from your experiences may help you to advance your practice and can be used to develop evidence to demonstrate your awareness and appreciation of your specialty.

Activities

  1. Attend a paediatric multidisciplinary team meeting.
  2. Attend an outpatient clinic e.g. transition clinics or epilepsy clinics.
  3. Attend a neurodevelopmental clinic.
  4. Shadow a health care professional on a neonatal ward.
  5. Attend a paediatric neurology or neonatal ward round.
  6. Shadow a paediatric epilepsy specialist nurse.
  7. Attend a sleep clinic.
  8. Sit in on paediatric EEG reporting session with medical consultant or consultant clinical scientist.

Academic content (MSc in Clinical Science)

Important information

The academic parts of this module will be detailed and communicated to you by your university. Please contact them if you have questions regarding this module and its assessments. The module titles in your MSc may not be exactly identical to the work-based modules shown in the e-portfolio. Your modules will be aligned, however, to ensure that your academic and work-based learning are complimentary.

Learning outcomes

On successful completion of this module, the student will be able to:

  1. Apply integrative understanding of the EEG development and features in the different paediatric ages.
  2. Explain the pathophysiology, clinical presentation and EEG findings in paediatric epileptic syndromes.
  3. Apply integrative understanding of the pathophysiology, clinical presentation and EEG findings in paediatric neurological disorders.
  4. Critically appraise and discuss the clinical significance and interpretation of the paediatric EEG.

Indicative content

EEG development:

  • EEG features according to conceptional age: preterm and full-term neonatal EEG
  • Maturation of awake and asleep EEG
  • Normal resting EEG, normal variants and the sleeping EEG in paediatric patients, to include infants in the first year of life, children and adolescences

Activation procedure their indications and contraindications:

  • Hyperventilation and photic stimulation
  • Sleep deprivation and drug-induced sleep

Paediatric epileptic syndromes:

Epileptic syndromes of infancy and early childhood:
  • Infantile spasms (West syndrome, Blitz-Nick-salaam Krämpfe)
  • Febrile convulsions
  • Benign myoclonic epilepsy and severe myoclonic epilepsy in infancy
  • Lennox-Gastaut syndrome
  • Epilepsy with myoclonic-astatic seisures
Epileptic syndromes of childhood:
  • Childhood absence epilepsy
  • Epilepsy with myoclonic absences
  • Benign partial epilepsies in children:
    • Benign childhood epilepsy with centro-temporal spikes
    • Childhood epilepsy with occipital paroxysms
    • Benign epilepsy with affective symptoms
    • Benign partial epilepsy with extreme somatosensory evoked potentials
    • Atypical benign partial epilepsy
    • Other forms of benign partial epilepsies
  • Epilepsy with continuous spike and slow wave during slow sleep (CSWS or ESES)
  • Acquired epileptic aphasia (Landau-Kleffner syndrome)
  • Chronic progressive epilepsia continua of childhood (Kojevnikov’s syndrome)
  • Epileptic syndromes of late childhood and adolescence
  • Juvenile absence and juvenile myoclonic epilepsy
  • Epilepsy with generalised tonic-clonic seisures on awakening
  • Primary reading and photosensitive epilepsy
  • Progressive myoclonic epilepsies of childhood and adolescence

Paediatric conditions of the nervous system:

  • Infection of the nervous system
    • Meningitis, encephalitis and Herpes simplex encephalitis
    • Tuberculous meningoencephalitis and cerebral thrombophlebitis
    • Cerebral malaria
    • Slow virus infections
    • Subacute sclerosing panencephalitis
    • HIV infections and AIDS
    • Rasmussen’s syndrome and Reye syndrome
  • Brain tumours and cerebral palsy.
  • Structural abnormalities
  • Paediatric metabolic conditions
  • Peroxisomal disorders
  • Lysosomal enzyme disorders and other leukodystrophies:
    • Neuronal ceroid lipofuscinosis, including Batten disease
  • Amino acid disorders and organic acidurias
  • Paediatric metabolic manifestations on the central nervous system
  • Endocrine disorders
  • Disturbances of carbohydrate metabolism
  • Disturbances of electrolyte balance
  • Learning difficulties and child psychiatry
    • Down’s, Fragile X, Angelman’s, Rett’s and Tourette’s
    • Autism and related disorders
    • Developmental dysphasia, including attention deficit hyperactivity disorder
    • Behavioural/conduct disorders/problems, including anorexia nervosa

Module assigned to

Specialties

Specialty code Specialty title Action
Specialty code SPS2-3-22 Specialty title Neurophysiology [2022] Action View
Specialty code SPS2-3-23 Specialty title Neurophysiology [2023] Action View
Specialty code SPS2-3-24 Specialty title Neurophysiology [2024] Action View
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