Curriculum


Fellows will receive exposure to each of the areas outlined below during their training.

All the studies will be performed initially under the supervision of Betty Soliven MD, Naoum P. Issa MD PhD, Kourosh Rezania MD, and Helene Rubeiz MD (three and a half to four days per week). After four to six months, a half day will be set aside for the fellow to do routine studies unsupervised, but the cases will be discussed with Betty Soliven MD or her designate.

  1. Epilepsy
    1. Overview - This subspecialty track consists of training in clinical neurophysiology focused on EEG and epilepsy. The main objective is to master skills necessary for recording and interpreting EEG and epilepsy monitoring studies and to develop competence in clinical management of patients with epilepsy.
    2. Clinical Duties - Fellows will be responsible for attending three one-half days of outpatient epilepsy clinic per week under the supervision of James Tao MD PhD, Naoum P. Issa MD PhD, Sandra Rose MD, Shasha Wu MD PhD. Exposure to multiple epilepsy attendings is desirable.
    3. EEG - Fellows will be responsible for pre-reading CNP laboratory EEGs daily, for reviewing these EEGs with an EEG attending daily, and for creating a final report. Fellows will also be on first call (phone) for emergency EEGs, whenever fellow duty hour regulations permit this.
    4. Long-term EEG Monitoring - Fellows will be responsible for pre-reading Epilepsy Monitoring Unit recordings daily, for reviewing these records with an Epilepsy attending, and for creating a final report. These recordings will include intracranial EEG from epilepsy surgery candidates, as well as routine scalp EEG monitoring. Fellows will be on first call (phone) for consultation by the neurology fellow regarding seizures in a patient being monitored, whenever fellow duty hour regulations permit this.
    5. Conferences - Fellows will be responsible for preparing materials for the monthly epilepsy surgery conferences. Data to be organized and presented include patient history and exam, EEG and video monitoring, radiographic and neuropsychological findings.
    6. Teaching - Initially fellows will be expected to assist EEG and Epilepsy attendings in teaching activities. After four to six months experience the fellows will be expected to progress from supervised to independent teaching of the basics of EEG and epilepsy monitoring to other CNP fellows, technologists, neurology residents, and medical students.
    7. Research Opportunities - Fellows are encouraged to participate in the ongoing clinical research of the Adult Epilepsy Center or to initiate new projects deemed appropriate by the Program Director.
  2. EEG/Evoked Potential/Intraoperative Monitoring
    1. Overview - This subspecialty track consists of training in clinical neurophysiology focused on evoked potentials of both outpatients and inpatients undergoing operative procedures. The main objective is to master skills necessary to record and interpret evoked potential studies and to develop competence in clinical management of patients being monitored during surgery.
    2. Clinical Duties - Fellows will be responsible for pre-reading CNP laboratory EPs daily, for reviewing these EPs with an EP attending (V. Leo Towle PhD, Sandra Rose MD) twice weekly daily, and for creating a final report. Fellows will also be on first call (phone) for emergency EPs, whenever fellow duty hour regulations permit this.
    3. Intraoperative Monitoring - Fellows will be expected to attend intraoperative monitoring sessions at least three half days per week under the supervision of Sandra Rose MD and to prepare monitoring reports.
    4. Teaching - Initially fellows will be expected to assist EP and Intraoperative Monitoring attendings in teaching activities. After four to six months experience the fellows will be expected to progress from supervised to independent teaching of the basics of EPs and intraoperative monitoring to other CNP residents, technologists, neurology residents, and medical students.
    5. Research Opportunities - Fellows are encouraged to participate in the ongoing clinical research or to initiate new projects deemed appropriate by the EP/IOM attendings.
  3. EMG/Neuromuscular
    1. Overview - This subspecialty track consists of training in clinical neurophysiology focused on electromyography and neuromuscular diseases. The main objective is to master electromyography skills and to develop competence in clinical management of patients with neuromuscular diseases.
    2. Clinical Duties - The fellow will attend one day per week in a neuromuscular clinic under the supervision of Betty Soliven MD, Kourosh Rezania MD, and Raymond Roos MD.
    3. EMG - The fellow is expected to obtain a brief history and examine the patient. All the studies will be performed initially under the supervision of Betty Soliven MD, John Jacobsen MD, Kourosh Rezania MD, and Helene Rubeiz MD (three and a half to four days per week). After four to six months, a half day will be set aside for the fellow to do routine studies unsupervised, but the cases will be discussed with Betty Soliven MD or her designate.
      • NCV and Reflex Studies
      • Repetitive nerve stimulation
      • Needle Exam
      • Quantitative Motor Unit Analysis and SFEMG (for second year fellows)
      • Autonomic and Quantitative Sensory Testing
      • Interpretation of Results (including writing the reports and communicating results to the referring physician in urgent cases):
        • Normal vs. Abnormal
        • Neuropathy vs. Myopathic vs. Neuromuscular Disorders
        • Radiculopathy vs. Plexopathy
        • Localization of Peripheral Nerve Entrapment
        • Axonal vs. Demyelinating Neuropathy
        • Motor Neuron Diseases
  4. Biopsy Interpretation - The fellow will spend two hours per week reading biopsies with Peter Pytel PhD.
  5. Conferences - The fellow will organize neuromuscular pathology conferences once a month (3:00pm to 4:00pm, alternating with neuropathology conference). The format will be a brief vignette, EMG and histological correlation to be coordinated with Peter Pytel PhD. This will be followed by brief literature review. In addition, the fellow will participate in grand rounds and neuromuscular lectures to residents.
  6. Teaching - Initially fellows will be expected to assist EMG attendings in teaching activities. After four to six months experience the fellows will be expected to progress from supervised to independent teaching of the basics of EMG and NCV studies to other CNP fellows, technologists, neurology residents, and medical students.
  7. Research Opportunities
    • Clinical trials where electrophysiological studies are required
    • EMG Case Reports and Reviews
    • Cross-sectional or prospective EMG studies; normative data for new programs
    • Animal physiology and patch clamp studies for senior fellows who may be interested
  8. Fellows that become interested in the basic science aspects of nerve and muscle diseases are encouraged to apply to the MDA for research fellowship grant.