During this rotation emphasis is on the following:
- Acute stroke management
- Stroke evaluation to determine etiology
- Application of the latest evidence on stroke care
Being one of the busiest stroke centers in the country, residents gain hands on experience on administering tpa, post tpa care and will see a wide spectrum of vascular disorders in patients ranging from young adults to the elderly.
General Neurology inpatient
Patients are admitted to the service from the UT Neurology clinics, through the ER, as transfers from surrounding hospitals or come from other countries for evaluation. Pathologies range from status epilepticus, myasthenic crisis, Guillain-Barre, Multiple Sclerosis exacerbations and more. The resident manages these patients under the direction of a general neurology attending.
General Neurology Consults (at MH-TMC)
Residents are exposed to the wide array of neurological conditions seen at a tertiary care, level I trauma center. Consults range from infectious meningo-encephalitis to seizure management to prognosis of recovery after anoxic brain injuries.
Residents have the opportunity to work in the state of the art 32 bed neuroICU caring for patients with severe strokes, post-operative neurosurgical patients and those general neurology patients requiring a high level of care due to their condition. Learning topics range from management of patients with elevated intracranial pressure, management of patients with subarachnoid hemorrhages and vasospasm and patients with spinal trauma.
This rotation is during the PGY4 year. The resident is responsible for overseeing the inpatient and consult services at MH-TMC and assisting the junior neurology residents as needed.
Epilepsy Monitoring Unit
Patients are admitted for a 3-5 day stay in the unit for continuous monitoring. Emphasis is placed on reviewing EEG recordings with the attending, adjustment of antiepileptic medications during the stay and eventually planning for epilepsy care after discharge.
The resident is responsible for presenting cases for the once weekly Epilepsy Case Conference. This conference is attended by epileptologists, epilepsy neurosurgeons, neuroradiologists and behavioral psychologists. Patients are presented and surgical options discussed with the entire team.
Residents also have the opportunity to go into the OR during the epilepsy surgery to witness intraoperative monitoring.
Residents are exposed to a wide variety of neurological deficits in various stages of progression while on the consultation service. Here the resident has the opportunity to truly act in the capacity of the consultant.
Residents work with the pediatric neurology fellows in managing both the inpatient and consult services and are exposed to a wide array of pediatric neurology conditions from seizures to mitochondrial disorders to developmental disorders like autism.
Part of the required neurology training curriculum, PGY4s spend 1 month with the psychiatry consultation team at MHH-TMC.
Ambulatory (includes subspecialty clinics- see below)
This rotation gives residents the opportunity to experience the different neurological subspecialties. Residents work one on one with the attendings in caring for the wide array of patients that come from Houston, other parts of Texas, the Gulf region, or even other parts of the country and the world.
Various months are available for electives (depending on the year of training), for a resident to explore more of the subspecialties in depth. Many residents also use their electives as a dedicated research month.
- General/Diagnostic neurology
- Multiple Sclerosis
- Neuromuscular (including nerve conduction studies/EMG)
- Movement disorders
- Vascular neurology
- Sleep Medicine
- Pediatric neurology
- Interventional neurology
- Neurocritical care