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Department of Neurology

Clinical Neurophysiology Fellowship Didactics

Master
Content

Epilepsy and Clinical Neurophysiology fellows have several educational conferences.

All incoming Epilepsy and Clinical Neurophysiology fellows will attend Boot Camp with several high yield epilepsy and neurophysiology lectures given over the first few days of the fellowship. A listing of the Boot camp lectures are as follows:

EEG

  • Normal Early Childhood, Neonatal and Premature EEG, Maturation
  • Normal Late Childhood and Adult EEG, including normal variants
  • EEG interictal epileptiform discharges and epileptic seizure patterns
  • EEG and focal lesions Lecture
  • Early Severe Neonatal and Infantile Epileptic Encephalopathy
  • EEG and encephalopathy, coma and death, including periodic patterns
  • EEG instrumentation - electrodes, amplifiers, analog and digital recording, filters and display
  • Classification of Seizures and Epilepsies using latest ILAE and ICD-10 terminology
  • Status epilepticus, particularly in the critically-ill patients
  • Interictal-Ictal Continuum
  • Practice of EEG (EEG review)

EMG/NCS

  • NCS, normal and abnormal and EMG/NCS Anatomy and Techniques, effects of temperature
  • EMG, Normal and Abnormal

Evoked Potentials

  • Evoked Potentials - VEP, BAEP, SEP basics

Sleep Medicine

  • Polysomnography History and Technique

For the first half of the year, fellows have weekly lectures from 12-1p on Thursdays and Fridays and Fridays 1-2 pm covering various clinical neurophysiology and epilepsy topics. A lecture breakdown is shown below.

Neurophysiology

  • Neurophysiology - potential - resting, action, conduction.  Generator anatomy and Mechanisms
  • EEG basic physiology, volume conduction, polarity and localization, near field and far field potentials
  • Computer Assisted EEG analysis
  • Neurophysiology - Synaptic Transmission in CNS and PNS
  • EEG technique, Artifacts, Electrical Safety
  • EEG and drug effects, anesthesia effects, EEG during Carotid Endarterectomy
  • Signal Averaging methodology
  • Primer to Intracranial EEG

Sleep

  • Narcolepsy diagnosis, MSLT, hypersomnia
  • Obstructive Sleep Apnea and related sleep related breathing disorders
  • Scoring Rules
  • Parasomnias - REM behavior disorder, PLMS, Jactatio Capitis, Somnambulism etc

Intraoperative Monitoring

  • Intraoperative Monitoring - Spine Surgery - SEPs, MEP, etc..
  • Intraoperative Monitoring - Intracranial Surgery - CN monitoring
  • Evoked Potentials - Abnormal
  • Intraoperative monitoring - Epilepsy surgery techniques of ECoG, Awake Craniotomy, Cortical Mapping
  • Evoked Potentials Case Review
  • IOM Introduction
  • IOM Case review

Clinical Epilepsy

  • Antiseizure medications emphasizing the newest medications
  • Open Loop Neurostimulation
  • Closed Loop Neurostimulation
  • Reflex Epilepsies and Provoked seizures
  • Adult Nonepileptic Events
  • Epilepsy and pregnancy
  • MEG
  • Wide Band EEG
  • RNS Fundamentals of Detection
  • RNS Fundamentals of Stimulation
  • RNS Practical use: PDMS, case examples
  • DBS practical use Lecture
  • VNS case based lecture
  • Ketogenic Diet
  • Febrile seizures
  • Neonatal epilepsies
  • Infantile epilepsies
  • Childhood epilepsies
  • Juvenile Epilepsies
  • Interictal-Ictal Continuum
  • Childhood epilepsy with Centrotemporal spikes
  • Pediatric Epilepsy Syndromes (EEG and Clinical pearls)
  • Cortical Mapping
  • Seizure Semiology
  • Epilepsy Surgery Zones
  • Transcranial Magnetic Stimulation
  • MRI imaging in Epilepsy
  • Nuclear Medicine Studies in Epilepsy

Neuromuscular

  • Pediatric EMG cases
  • EMG, normal and abnormal
  • Special EMG/NCS techniques - repetitive stimulation, Single Fiber EMG, Autonomic Testing
  • EMG/NCS Clinical Correlations for peripheral nerve disorders
  • Pediatric Neuromuscular disorders
  • EMG Board Review
  • EMG clinical correlations for NMJ, CNS, muscle disorders and movement disorders

Genetics of Epilepsy

  • Epilepsy Genetics 101
  • Epidemiology of genetic epilepsies and epilepsy genetics research - outcomes and clinical relevance (familial studies, trio analyses, GWAS)
  • Neonatal/infantile epilepsy syndromes
  • Childhood genetic epilepsy syndromes
  • Epilepsy syndromes in adolescence and adulthood
  • Focal genetic epilepsies
  • Metabolic genetic epilepsies
  • Precision therapy in epilepsy
  • Pharmacogenetics
  • Genetic counseling
  • SUDEP genetics
  • Case studies, wrap up

In the second half of the year, the Thursday and Friday 12-1p and Friday 1-2p slots also include:

Journal club: Presenting fellow works with faculty mentor to present two relevant journal articles, one with an emphasis on clinical neurophysiology and one with an epilepsy emphasis

Interesting EEGs: Fellows present interesting EEGs seen at the various teaching sites for discussion with other fellows and faculty that are present

Other educational conferences include a neonatal EEG review session held every 2 weeks over the second half of the year led by Drs. Mizrahi and Seto and fellow directed learning sessions based on the AES Fellowship Curriculum Modules (https://www.aesnet.org/professional_education/fellowship_curriculum).