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Test Your Expertise in the Diagnosis and Management of Rare Pediatric Epilepsies

  • Authors: Elaine C. Wirrell, MD
  • CME / ABIM MOC Released: 3/16/2023
  • Valid for credit through: 3/16/2024
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  • Credits Available

    Physicians - maximum of 1.00 AMA PRA Category 1 Credit(s)™

    ABIM Diplomates - maximum of 1.00 ABIM MOC points

    You Are Eligible For

    • Letter of Completion
    • ABIM MOC points

Target Audience and Goal Statement

This activity is intended for neurologists, pediatricians, and psychiatrists.

The goal of this activity is for learners to be better able to accurately diagnose and effectively manage patients with Lennox-Gastaut syndrome (LGS) and Dravet syndrome (DS).

Upon completion of this activity, participants will:

  • Have greater competence related to
    • Selection of appropriate assessment tools for a pediatric patient with seizures
    • Accurate diagnosis of a rare pediatric epilepsy
    • Selection of an appropriate antiseizure medication (ASM) for the management of a rare pediatric epilepsy


Medscape, LLC requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated. Others involved in the planning of this activity have no relevant financial relationships.

Disclosures for additional planners can be found here.


  • Elaine C. Wirrell, MD

    Professor of Neurology
    Divisions of Child and Adolescent Neurology and Epilepsy
    Department of Neurology
    Chair of Child and Adolescent Neurology
    Mayo Clinic
    Rochester, Minnesota


    Elaine C. Wirrell, MD, has the following relevant financial relationships:
    Consultant or advisor for: BioMarin Pharmaceutical, Inc.; Eisai, Inc.
    Research funding from: Biocodex; Jazz Pharmaceuticals, Inc.; Marinus Pharmaceuticals; Stoke Therapeutics; Takeda; Zogenix, Inc.


  • Frances McFarland, PhD, MA

    Medical Education Director, Medscape, LLC


    Frances McFarland, PhD, MA, has no relevant financial relationships.

  • Megan Breuer, PhD

    Medical Writer, Medscape, LLC


    Megan Breuer, PhD, has the following relevant financial relationships:
    Consultant/advisor: Paratek Pharmaceuticals, Inc. (former)
    Owns stock (publicly traded) in: Bristol Myers Squibb Company; Johnson and Johnson; Paratek Pharmaceuticals, Inc.; Vertex Pharmaceuticals Inc.

Compliance Reviewer

  • Leigh Schmidt, MSN, RN, CNE, CHCP

    Associate Director, Accreditation and Compliance, Medscape, LLC


    Leigh Schmidt, MSN, RN, CNE, CHCP, has no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has no relevant financial relationships.

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In support of improving patient care, Medscape, LLC is jointly accredited with commendation by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

    For Physicians

  • Medscape, LLC designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

    The European Union of Medical Specialists (UEMS)-European Accreditation Council for Continuing Medical Education (EACCME) has an agreement of mutual recognition of continuing medical education (CME) credit with the American Medical Association (AMA). European physicians interested in converting AMA PRA Category 1 credit™ into European CME credit (ECMEC) should contact the UEMS (

    College of Family Physicians of Canada Mainpro+® participants may claim certified credits for any AMA PRA Category 1 credit(s)™, up to a maximum of 50 credits per five-year cycle. Any additional credits are eligible as non-certified credits. College of Family Physicians of Canada (CFPC) members must log into Mainpro+® to claim this activity.

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Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 75% on the post-test.

Follow these steps to earn CME/CE credit*:

  1. Read the target audience, learning objectives, and author disclosures.
  2. Study the educational content online or printed out.
  3. Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. We encourage you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates from the CME/CE Tracker.

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Test Your Expertise in the Diagnosis and Management of Rare Pediatric Epilepsies

Authors: Elaine C. Wirrell, MDFaculty and Disclosures

CME / ABIM MOC Released: 3/16/2023

Valid for credit through: 3/16/2024



  1. Symonds JD, et al. Early childhood epilepsies: epidemiology, classification, aetiology, and socio-economic determinants. Brain. 2021;144:2879-2891.
  2. Berg AT, et al. Early-life epilepsies and the emerging role of genetic testing. JAMA Pediatr. 2017;171:863-871.
  3. Dravet C. The core Dravet syndrome phenotype. Epilepsia. 2011;52:3-9.
  4. Zuberi SM, et al. ILAE classification and definition of epilepsy syndromes with onset in neonates and infants: position statement by the ILAE Task Force on Nosology and Definitions. Epilepsia. 2022;63:1349-1397.
  5. Hattori J, et al. A screening test for the prediction of Dravet syndrome before one year of age. Epilepsia. 2008;49:626-633.
  6. Raga S, et al. Developmental and epileptic encephalopathies: recognition and approaches to care. Epileptic Disord. 2021;23:40-52.
  7. Hebbar M, et al. Recent advances in epilepsy genomics and genetic testing. F1000Res. 2020;9:F1000 Faculty Rev - 185.
  8. Wheless JW, et al. Dravet syndrome: a review of current management. Pediatr Neurol. 2020;107:28-40.
  9. Silvennoinen K, et al. Late diagnoses of Dravet syndrome: how many individuals are we missing? Epilepsia Open. 2021;6:770-776.
  10. Brunklaus A, et al. The gain of function SCN1A disorder spectrum: novel epilepsy phenotypes and therapeutic implications. Brain. 2022;145:3816-3831.
  11. Scheffer IE. Solving the molecular basis of the developmental and epileptic encephalopathies: are we there yet? Epilepsy Curr. 2021;21:430-432.
  12. Specchio N, et al. International League Against Epilepsy classification and definition of epilepsy syndromes with onset in childhood: position paper by the ILAE Task Force on Nosology and Definitions. Epilepsia. 2022;63:198-1442.
  13. Brunklaus A, et al. Development and validation of a prediction model for early diagnosis of SCN1A-related epilepsies. Neurology. 2022;98:e1163-e1174.
  14. The Broad Institute. The SCN1A-Epilepsy Prediction Model. 2022. Accessed February 16, 2023.
  15. Li W, et al. Defining Dravet syndrome: an essential pre‐requisite for precision medicine trials. Epilepsia. 2021;69:2205-2217.
  16. Wirrell EC, et al. International consensus on diagnosis and management of Dravet syndrome. Epilepsia. 2022;63:1761-1777.
  17. Lagae L, et al. Fenfluramine hydrochloride for the treatment of seizures in Dravet syndrome: a randomised, double-blind, placebo-controlled trial. Lancet. 2019;394:2243-2254.
  18. Nabbout R, et al. Fenfluramine for treatment-resistant seizures in patients with Dravet syndrome receiving stiripentol-inclusive regimens: a randomized clinical trial. JAMA Neurol. 2020;77:300-308.
  19. Devinsky O, et al. Effect of cannabidiol on drop seizures in the Lennox-Gastaut syndrome. N Engl J Med. 2018;378:1888-1897.
  20. Chiron C, et al. Stiripentol in severe myoclonic epilepsy in infancy: a randomised placebo-controlled syndrome-dedicated trial. STICLO study group. Lancet. 2000;356:1638-1642.
  21. Boyce DM, et al. Barriers to transition from pediatric to adult care for patients with Dravet syndrome: a focus group study of caregivers. 2020;109:107096.
  22. Cross JH, et al. Expert opinion on the management of Lennox-Gastaut syndrome: treatment algorithms and practical considerations. Front Neurol. 2017;8:505.
  23. Strzelczyk A, et al. Expanding the treatment landscape for Lennox-Gastaut syndrome: current and future strategies. CNS Drugs. 2021;35:61-83.
  24. Cannabidiol [prescribing information]. Initial US approval 2018. Revised April 2020.
  25. Motte J, et al. Lamotrigine for generalized seizures associated with the Lennox-Gastaut syndrome. N Engl J Med. 1997;337:1807-1812.
  26. Sachedo RC, et al. A double-blind, randomized trial of topiramate in Lennox-Gastaut syndrome. Neurology. 1999;52:1882-1887.
  27. Conry JA, et al. Clobazam in the treatment of Lennox‐Gastaut syndrome. Epilepsia. 2009;50:1158-1166.
  28. Conry JA, et al. Stable dosages of clobazam for Lennox-Gastaut syndrome are associated with sustained drop-seizure and total-seizure improvements over 3 years. Epilepsia. 2014;55:558-567.
  29. Glauser T, et al. Rufinamide for generalized seizures associated with Lennox-Gastaut syndrome. Neurology. 2008;70:1950-1958.
  30. Dodson WE. Felbamate in the treatment of Lennox‐Gastaut syndrome: results of a 12‐month open‐label study following a randomized clinical trial. Epilepsia. 1993;34:S18-S24.
  31. Knupp KG, et al. Efficacy and safety of fenfluramine for the treatment of seizures associated with Lennox-Gastaut syndrome: a randomized clinical trial. JAMA Neurol. 2022;79:554-564.
  32. Novak GP, et al. Carisbamate (RWJ-333369). Neurotherapeutics. 2007;4:106-109.
  33. Mula M. Recent and future antiepileptic drugs and their impact on cognition: what can we expect? Expert Rev Neurother. 2012;12:667-671.
  34. Knight EMP, et al. Safety and efficacy of ganaxolone in patients with CDKL5 deficiency disorder: results from the double-blind phase of a randomised, placebo-controlled, phase 3 trial. Lancet Neurol. 2022;21:417-427.
  35. Open-label, long-term safety study of LP352 in subjects with developmental and epileptic encephalopathy. Accessed February 16, 2023.
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