Epilepsy Clinic

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 . . .
#DescriptionMilestones
1Obtain a history, exam the patient and classify the events and the epilepsy syndromePC1, PC2, PC3, MK1, PC12
2Develop patients’ treatment plansPC4, PL1
3Appropriately utilize ancillary testing data (EEG, MRI, neuropsychological etc.. ) to refine diagnosis and treatment of epilepsyPC4, PC8, PC9, MK2
4Counsel patients with spells/epilepsy regarding study resultsPC8, PC9, MK2, IC1
5Counsel patients on indications and contraindications for dietary therapy for epilepsy and develop patients’ treatment plansPC4, PL1, IC1
6Counsel patients on indications and contraindications for VNS/RNS therapy for epilepsy and develop a treatment planPC4, PL1, IC1
7Counsel patients on SUDEP, Women’s Health issues, and AED medication side-effectsPC4, 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.

 MondayTuesdayWednesdayThursdayFriday
AMEpilepsy EpilepsyEpilepsyEpilepsyEpilepsy
UWUWUWUWReading/Admin
PMEpilepsyEpilepsyEpilepsyEpilepsyEpilepsy
UWUWUWReading/AdminUW

 

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.17239https://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