Introduction
Outpatient Epilepsy time will be in accordance with the Fellow’s training emphasis and in consideration of other prior clinical background. Weekly Epilepsy clinic is required for EMU and LTM rotation weeks.
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Weekly Clinics
The fellow will attend an epilepsy clinic one half-day per week at UW under the supervision of a faculty epileptologist. The goal is to work with the same provider each week to get some continuity with longitudinal patient care. If the same faculty is out due to vacation or being on service, the fellow will work with another attending that day. This clinic has a mix of new and return patients. The fellow must clearly communicate to applicable faculty and trainees that they will be unavailable for other clinical duties during these clinics, and immediately report any potential conflicts to the program director to resolve.
All adult epilepsy fellows will also attend the epilepsy clinic one half-day per week at the VA during EEG rotation.
Pediatric epilepsy fellows will have a designated continuity clinic on Wednesday afternoons.
Clinic Rotation (as an elective)
The clinics rotation is a chance for fellows to go to clinic with providers who are not their primary attending for the longitudinal clinic. This is a chance for the fellow to spend time in our dietary epilepsy clinic.
Adult and Pediatric Epilepsy Fellow Goals
The goal of the weekly epilepsy clinics is for fellows to learn to provide longitudinal care to epilepsy patients. The goal of the more specialized clinics is to learn about non-pharmacologic treatment of epilepsy through experience in the dietary epilepsy clinic and neuro-stimulation clinic. They are to recognize that they are part of a team.
Epilepsy Fellow Objectives and Evaluation Matrix
Epilepsy Clinics Rotation ObjectivesUpon completion of the curriculum, fellows will… |
| # | Description | Milestones |
| Evaluate patients who have been diagnosed with epilepsy or have symptoms consistent with epilepsy, formulate their cases, and propose appropriate diagnostic and therapeutic plans | PC1, PC2, PC3, MK1, MK3, SP3, SP4, PR1, IC1, IC3, IC5 | |
| Appropriately order and interpret neuroimaging, EEG, and laboratory studies | PC3, MK3 | |
| Counsel patients and their families regarding their diagnoses, prognoses, and treatment options | PC1, PC2, PC3, MK1, MK3 | |
| Clearly document and place orders in Health Link and follow up on the results of tests | PC1, PC2, PC3, MK1, MK3 |
| Additional Milestones |
SP4, PL1, PL2, PR1, PR2, PR3, IC2, IC4, IC5, PC6 |
Schedules
Adult Epilepsy Fellow Schedule
These clinics alternate between the UW and VA, according to clinic space needs.
Pediatric Epilepsy Fellow Schedule
Pediatric epilepsy fellows will have a designated continuity clinic on Wednesday afternoons. They will have 2 slots in which to see new or follow up patients; these patients will be staffed by either one of the pediatric epileptologists with Wednesday afternoon clinic or by the Pediatric Epilepsy Consult attending. The pediatric epilepsy fellow will be responsible for managing phone calls and myChart messages from patients seen in their continuity clinic, seeking out supervision as necessary. If time permits, the fellow will see other patients scheduled with the pediatric epilepsy provider, but will not be expected to write documentation for these patients. For designated clinic blocks, pediatric fellows will attend a variety of pediatric and adult epilepsy clinics, including pediatric and adult dietary epilepsy clinic and neurostimulation clinic.
If a clinic must be cancelled for a vacation, professional conference, etc., then this must be requested at least 60 days in advance. This allows the department to review the request internally and still comply with the UW and VA hospitals’ policies, which require 45 days’ notice.
Conferences
Attend per conference requirements, clinics do not overlap with conference times.
Work Hours
standard
Epilepsy Clinic References
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
Latest revision: 06/10/2024, Aaron Struck, MD and Andrew Knox, MD
