Director: Pedro Mancias, MD
The goal of the training in neurophysiology is to provide the resident with the opportunity to develop the expertise necessary to evaluate and manage patients using the procedures and techniques of neurophysiology.
It is the intent of the neurophysiology-training program to develop neurologists into competent clinical neurophysiologists. Neurologists successfully completing the program will be eligible for certification by American Board of Psychiatry and Neurology. Objective is to provide the resident with the opportunity to develop the expertise necessary to evaluate and manage patients using the procedures and techniques of clinical neurophysiology and that all trainees will pass the examination.
Clinical neurophysiology includes the assessment of selective neurological disorders involving central, peripheral and autonomic nervous systems and muscles. Assessment, monitoring and treatment is involved in electrophysiological testing in combination with clinical evaluation.
The goals of our training program include extensive in evoked potential studies, motor and sensory conduction studies, diagnostic electromyography, electroencephalography, video EEG (on EEG track) and polysomnography. Familiarity with single fiber electromyography, electrodiagnostic movement disorder assessment, intraoperative monitoring, video EEG monitoring (for EMG track) and autonomic function is included.
Clinical competence in clinical neurophysiology requires:
- A solid fund of basic clinical knowledge and the ability to maintain it at current levels for a lifetime of continuous education.
- The ability to perform an adequate history and physical examination.
- The ability to appropriately order and interpret diagnostic tests.
- Adequate technical skills to carry out selected diagnostic procedures.
- Clinical judgement to critically apply the above data to individual patients.
- Attitudes conducive to the practice of neurology, including appropriate interpersonal interactions with patients, professional colleagues, and supervisory faculty and all paramedical personnel.
- Personal integrity.
- Regular, timely attendance at educational activities in the department of neurology.
- Timely dictation of test reports and appropriate letters and telephone calls to referring physicians.
- Recognition of professional limits. Controversial issues require direct and immediate participation of the responsible attending supervising physician.
- Basic neuroscience pertaining to clinical neurophysiology include knowledge in neuroanatomy, neuropharmacolgoy, neurophysiology, neurochemistry and neuropathology in normal and disease states.
The fellow will have instruction and practical experience to permit him or her to develop diagnostic, procedural, technical, and interventional skills essential to the performance of clinical neurophysiology. The experience includes opportunities to observe, evaluate, and manage inpatients and outpatients of all ages with a wide variety of disorders of the nervous system and muscles, as well as to learn the effectiveness of procedures. The opportunity includes experience in clinical diagnosis and accumulation /interpretation of laboratory data relevant to these disorders as part of outpatient and inpatient diagnostic evaluations with good support from pathology and radiology. Basic clinical knowledge should include the neurophysiology aspects of the following disease processes of the nervous system:
- cerebrovascular disease
- dementia and encephalopathies (coma, stupor, confusion, developmental delay, regression)
- multiple sclerosis (including other demyelinating disorders)
- movement disorders
- brain tumors and other mass lesions
- sleep disorders
- traumatic disorders
- motor neuron disease
- radiculopathies and plexopathies
- myopathies and neuromuscular transmission disorders
- Another application of increasing importance is the use of intraoperative monitoring to guide surgical interventions
Basic and clinical neurophysiology topics will be covered during the one year training period through a combination of clinical experience of both in and outpatient, basic neuroscience conferences, EMG neuromuscular disease conferences and EEG epilepsy conferences including evoked potentials interoperative monitoring and other areas of clinical neurophysiology such as autonomic testing EMG and the basic physiology of sleep.