Introduction and Goals
This rotation is a clinical experience elective that can be taken at any time with the following goals:
For PGY-2 residents who choose this elective, the primary educational goal is to provide exposure to the diagnosis of seizures and their differential diagnosis, types of epilepsy/epilepsy syndromes and initial management of first-time seizures and new diagnosis of epilepsy.
For PGY-3-4 residents, the goal is to develop competence in managing patients with epilepsy including management of drug resistant epilepsy with an understanding of rational polypharmacy and the planning for advance interventions/investigations such as surgical evaluation, use of devices and ketogenic diet therapy.
Objectives and Evaluation Matrix
As with all of the neurology rotations, the specific objectives are reflected in the entrustable professional activities and individual milestones listed below. These form the basis for the end-of-rotation evaluation. (Please see the section End-of-Rotation Evaluations above for the list of milestone abbreviations).
| Epi Clinics Rotation Objectives | ||
| Upon completion of the curriculum, residents will . . . | ||
| # | Description | Milestones |
| 1 | Obtain a history, exam the patient and classify the events and the epilepsy syndrome | PC1, PC2, PC3, MK1, PC12 |
| 2 | Develop patients’ treatment plans | PC4, PL1 |
| 3 | Appropriately utilize ancillary testing data (EEG, MRI, neuropsychological etc.. ) to refine diagnosis and treatment of epilepsy | PC4, PC8, PC9, MK2 |
| 4 | Counsel patients with spells/epilepsy regarding study results | PC8, PC9, MK2, IC1 |
| 5 | Counsel patients on indications and contraindications for dietary therapy for epilepsy and develop patients’ treatment plans | PC4, PL1, IC1 |
| 6 | Counsel patients on indications and contraindications for VNS/RNS therapy for epilepsy and develop a treatment plan | PC4, PL1, IC1 |
| 7 | Counsel patients on SUDEP, Women’s Health issues, and AED medication side-effects | PC4, PL1, IC1 |
| Milestones | ||
| Please grade the resident on any of the following milestones you were able to evaluate during this rotation: | ||
| SP1, PL2, PR1, PR2, IC2, IC3 | ||
Schedule
Below is a sample schedule for this rotation, including a combination of clinic time with epilepsy attendings as well as clinics with APPs. This schedule is subject to attending availability; accordingly, this elective may not be able to be offered during weeks when multiple attendings are out of clinic (for example, national conference weeks or holidays).
The below schedule can, within certain parameters, be adjusted to address specific resident learning goals for the rotation. If there are specific requests for scheduling, these should be included in the elective request form and sent to the Program Coordinators. An individualized schedule will be emailed to the resident the week before the rotation.
| Monday | Tuesday | Wednesday | Thursday | Friday | |
| AM | Epilepsy | Epilepsy | Epilepsy | Epilepsy | Epilepsy |
| UW | UW | UW | UW | Reading/Admin | |
| PM | Epilepsy | Epilepsy | Epilepsy | Epilepsy | Epilepsy |
| UW | UW | UW | Reading/Admin | UW |
Work Hours
There are no call or weekend responsibilities during this rotation. The total hours per week at this clinic is expected to be 32.
Suggested References
Continuum Epilepsy April 2022, Volume 28, Issue 2
Zuberi SM, Wirrell E, Yozawitz E, Wilmshurst JM, Specchio N, Riney K, 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. https://doi.org/10.1111/epi.17239– https://onlinelibrary.wiley.com/doi/10.1111/epi.17239
Specchio N, Wirrell EC, Scheffer IE, Nabbout R, Riney K, Samia P, 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: 1398–1442. https://doi.org/10.1111/epi.17241 – https://onlinelibrary.wiley.com/doi/10.1111/epi.17241
Riney K, Bogacz A, Somerville E, Hirsch E, Nabbout R, Scheffer IE, et al. International League Against Epilepsy classification and definition of epilepsy syndromes with onset at a variable age: position statement by the ILAE Task Force on Nosology and Definitions. Epilepsia. 2022; 63: 1443–1474. https://doi.org/10.1111/epi.17240 – https://onlinelibrary.wiley.com/doi/10.1111/epi.17240
Hirsch E, French J, Scheffer IE, Bogacz A, Alsaadi T, Sperling MR, et al. ILAE definition of the Idiopathic Generalized Epilepsy Syndromes: Po sition statement by the ILAE Task Force on Nosology and Definitions. Epilepsia. 2022; 63: 1475–1499. https://doi.org/10.1111/epi.17236 https://onlinelibrary.wiley.com/doi/10.1111/epi.17236
Beniczky, S., Tatum, W.O., Blumenfeld, H., Stefan, H., Mani, J., Maillard, L., Fahoum, F., Vinayan, K.P., Mayor, L.C., Vlachou, M., Seeck, M., Ryvlin, P. and Kahane, P. (2022), Seizure semiology: ILAE glossary of terms and their significance. Epileptic Disorders, 24: 447-495. https://doi.org/10.1684/epd.2022.1430
https://onlinelibrary.wiley.com/doi/10.1684/epd.2022.1430
Latest revision: 04-26-2024, Natalie Wheeler
