EEG

Introduction

The Epilepsy rotation combines inpatient and outpatient EEG reading, epilepsy monitoring unit and outpatient clinic experiences in a 1-week block. This is a foundational experience with close daily interactions with the attending and other members of the team including inpatient hospital staff and EEG technicians. Daily EEG readings include routine and continuous monitoring studies, as well as analysis of EMU patient data which may include scalp or intracranial EEGs, integration with imaging data such as fMRI, PET or SPECT, and bedside mapping.  Fellows provide preliminary readings of most EEG studies, and review all studies with the attending physician.

 

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ACGME Competency Goals

Patient Care

Goals: The fellow will be able to recognize and provide appropriate treatment for various epilepsy syndromes as well as the treatment of status epilepticus.

Medical knowledge

Goals: The fellow will understand the basic principles of EEG from electrode placement, amplifiers, and digital signal processing. The fellow will be able to determine common EEG artifact, benign variants, normal background patterns in awake, drowsy, sleep in pediatrics and adults.

Interpersonal and Communication Skills

Goals: The fellow will be diligent and thorough in hand-offs. The fellow will maintain a professional demeanor during all interpersonal communications. The fellow communications with treating providers will be effective in regards to EEG findings and interpretation of these findings within the clinical context of patient.

Practice-Based Learning and Improvement 

Goals: The fellow will be involved in improving the quality of the care of epilepsy patients and others with critical neurological illness through QI projects, scholarly activities, and/or participation in weekly multi-disciplinary EEG/epilepsy conferences which include peer-review and practice improvement.

Professionalism

Goals: The fellow will be professional in verbal communications and in timely reporting of EEG studies and notes.

Systems-Based Practice

Goals: The fellow recognizes that he/she is part of a treatment team and participates within the treatment group effectively. The treatment groups including neurology/neurocritical care, neuroradiology, neurosurgery, and EEG technologists.

Objectives and Evaluation Matrix

As with all of the individual rotations described in this section, the specific objectives of the continuity clinic are reflected in the entrustable professional activities and individual milestones. These form the basis for the fellow’s evaluation, which is completed by his or her clinic attending twice each year. (Please see the section End-of-Rotation Evaluations above for the list of milestone abbreviations).

EEG Rotation Objectives

Upon completion of the curriculum, fellows will . . .

EPA #EPA DescriptionMilestones
1Interpret routine outpatient and inpatient EEG in adultsPC3, MK3
2Interpret continuous video inpatient EEGs, including providing assistance in the management of inpatients with seizure disorders including status epilepticusPC1, PC2, PC3, MK1, MK3, SP3
3Understand seizure semiology and electrographic localization of seizuresPC1, PC2, PC3, MK1, MK3
4Describe placement and interpretation of intracranial EEG monitoring in the work-up for epilepsy surgeryPC1, PC2, PC3, MK1, MK3
5Develop a treatment plan for patient admitted to the epilepsy monitoring unitPC1, PC2, PC3, MK1, MK4
6Demonstrate professionalism and  communicates  effectively with Neurophysiology Technologists, nurses, ordering providers and other team membersSP3, PR1, PR2, PR3, IC4, IC5
7Participate in family meetings regarding goals of care and help negotiate conflicts among family members and the treatment teamIC1, IC2, IC3

Latest revision: 10-28-2022, Aaron Struck, MD

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