Deanery Advisers Pack
British Paediatric Neurology Association
Higher Specialist Training Syllabus
Revised January 2001
Read in conjunction with the sections on Neurology, Learning Difficulties and Development
in the General Professional Training Syllabus.
Y1A Knowledge of Paediatric Neurology
1. Wide range of normal and abnormal patterns of development.
2. Neonatal neurology with an understanding of the principles of ante-natal brain
development, brain injury and its investigation.
3. Epidemiology, aetiology, pathogenesis, pathology, clinical features, treatment and
outcome measures for:
a) neurological diseases in childhood.
b) the common paroxysmal disorders, including epilepsy, sleep disorders and
c) the causes of developmental delay, learning disability and specific learning
difficulties - to include an understanding of language and complex
communication disorders (autistic spectrum).
4. Neurological emergencies in childhood, eg, presenting with coma, status
epilepticus, raised intracranial pressure and paediatric emergencies presenting with
neurological features eg, metabolic disorders, non-accidental injury.
5. lnter-relationship of neurological diseases with other body systems including
growth and nutrition: feeding difficulties, reflux and aspiration.
6. Orthopaedics, orthotics and bioengineering in the clinical setting.
7. Genetic issues including recurrence risk, prenatal diagnosis, gene localisation and
Y1B Diagnostic Methods
1. Prenatal diagnosis as it relates to neurological disorder.
2. Biochemical changes in blood and CSF and haematological changes that may
accompany neurological disorder in children.
3. Genetic and immunological basis of some neurological disorders: methodology
4. Use of tissue biopsy: interpretation of histological abnormalities.
5. Appropriate use of neuroradiology and other screening modalities.
6. Clinical neurophysiology including EEG, EMG and nerve conduction studies.
As with other technical procedures (see below) trainees are not expected to
become proficient in all aspects of clinical neurophysiology, though a good
working knowledge of standard procedures is required. If a consultant
appointment requires reporting skills then a further period of training should be
arranged if appropriate. A few trainees will wish to become a paediatric
clinical neurophysiologist; a training programme following two years in
paediatric neurology has been agreed.
8. Assessment of hearing and vision including behavioural, brainstem, auditory
evoked potentials, electroretinography and visual evoked potentials.
9. Neurometabolic investigations.
10. Principles of gait analysis.
1. Familiarity with current standard treatment plans for all forms of neurological
2. Thorough knowledge of drugs used in treatment, especially antiepileptic drugs,
steroids and other immunosuppressants, muscle relaxants, analgesics, gastro-
protective drugs, anti-bacterial and anti-viral agents and behaviour modifying
3. Principles underlying rehabilitation.
4. Principles of management of behaviour disorders including pharmacotherapy,
counselling and psychotherapy (this knowledge will be gained in a module in
child and adolescent psychiatry).
5. Aids to treatment and rehabilitation, hearing and vision aids, seating, mobility
aids, orthoses, communication,aids, computers etc.
6. Awareness of range and potential consequences of unconventional and
Y1D Multidisciplinary Care
1. Use a team approach to management of neurological disorders and understand
its advantages and limitations.
2. Understand methods used by occupational, speech and physiotherapists, nurses,
specialist health visitors, play therapists, dieticians, clinical, neuro- and
educational psychologists, teachers and social workers in assessment (with a
knowledge of the basis and strengths of neuro-psychometric assessment),
treatment and rehabilitation.
3. Knowledge of methods used by other medical specialists including the
ophthalmologist, ENT surgeon, community paediatrician, child and adolescent
4. Community Child Health Services.
5. Function of the Child Development Service including outreach child
6. Special Needs Registers.
7. Transition of care from children's to adult services.
Y1E Integrated Care - Work with other Agencies
1. Statement of educational needs - Education Acts 1981 and 1993 or separate
Scottish legislation; interface with the Education Department: learning disability
teams mainstream and special schools.
2. Child protection - the 1989 Children Act or separate Scottish legislation. Social
Service provision including respite care, care support and benefits.
3. Self help and parent support groups.
Y1F Ethical Issues
1. Ethics of research in children.
2. Process of informed consent.
3. Knowledge of issues governing ethics and consent for clinical trials.
4. United Nations Convention of the Rights of a Child and other relevant
proclamations and judgements set down in law.
1. Understanding of the management skills required for the development and use of
resources in the neurology unit, including budget control, contracting, strategic
planning and writing a business plan.
2. Experience the day-to-day running of a paediatric neurology service within the
medical directorate system.
3. Knowledge of and involvement in clinical audit.
4. The structure and function of local, regional and national NHS organisation.
5. Knowledge of research funding - grants, charities and NHS R&D support.
1. Developmental assessment.
2. Detailed neurological examination.
3. Interpret results of investigations including EEG, EMG, nerve conduction, CT
and MRI scans.
4. Draw up a management plan taking into account continuing medical problems
and attendant social, educational and psychological factors.
5. Co-ordination of care for the critically ill child: the management of neurological
Trainees are not asked to be proficient with all these investigations but rather to be
familiar with them and to understand their inherent strengths and weaknesses.
Trainees should be competent at performing tests to determine brain death.
2. Nerve conduction studies
3. Skin biopsy
4. Muscle biopsy
5. Cerebral pressure monitoring line care
6. Perform tests to determine brain death
7. Neonatal cranial ultrasound
8. Muscle ultrasound
9. Cerebral function monitoring
1. Critical evaluation of clinical results from literature review and audit.
2. Manuscript preparation.
3. Oral presentation skills.
Routine departmental tasks including duty rotas, teaching programmes, Postgraduate
1. Formal and informal teaching skills at undergraduate and postgraduate level.
2. Development of a core teaching material to enable participation in teaching
programmes on a regular basis.
Understanding and implementing a leadership role in a multidisciplinary team
1. Effective and appropriate approach to parents and children in the consultation
setting with particular reference to giving them the news that they will have a
continuing or disabling condition and to be able to give guidance in broad terms
on prognosis; to have a good working knowledge of other information available
- written, audio, video or CD-ROM, and the internet - to complement what was
said in the consultation and to have knowledge of family support groups
(especially Contact-a Family).
2. Effective and appropriate approach to colleagues, GPs, community health care
staff, research and laboratory staff and managers.
1. Commitment to continuing self-education and the teaching of others.
2. Maintenance of a training experience portfolio.
1. Maintenance of a training experience portfolio.
2. Understanding and positive approach to the supervision of junior medical staff.
3. Recognition of and coping with stress in self and others.
1. Recognition of and coping with stress in self and others.
2. Support to/active in research.
3. Collaborative attitude to local and national colleagues.
1. Interest in the overall organisation of departmental activities and in particular its
function as an effective Regional/tertiary centre with its outreach clinics.
2. Understanding approach to local management structure.
3. Constructive attitude to the processes of decision making.
4. Acceptance of shared responsibility for use of resources.
5. Ability to understand clinical complaints procedures and to respond effectively
BPNA Training Committee