Epilepsy and Clinical Electroencephalography

Neurology 685

Clerkship site: Harborview Medical Center

Preceptor: Shahin Hakimian, M.D.

Course description: Medical students will receive an introduction into epilepsy and the use and interpretation of the electroencephalogram and other clinical studies used to assess it. Each student will be under the direct supervision of several of the faculty epileptologists and clinical neurophysiologists.

Electroencephalography is particularly valuable in confirming the diagnosis of and forming the basis for the classification of the different types of human epilepsy. Expanded use of the EEG includes electrocorticography, where direct recording of the brain’s electrical activity is obtained at the time of epilepsy surgery and helps to guide the removal of abnormal brain tissues. EEG linked to video-audio systems is the basis for long-term epilepsy monitoring, where clinical and electrical events during a given seizure are correlated for patient management and care. The results of long-term epilepsy monitoring are frequently utilized to guide epilepsy surgery.

This clerkship is also designed to give experience and training in the evaluation and treatment of epileptic seizures and other spells. Will include working one on one with Epilepsy Center faculty in the outpatient setting, managing patients during long video EEG monitoring, and attendance at Epilepsy Center conferences and lectures. Experience in pediatric epilepsy can be arranged as appropriate. Participation in research can also be arranged on an individual basis as a separate experience.

Goals and objectives:

  1. Acquire a familarity with the clinical role of EEG.
    • Benchmark: Students will learn the clinical indications for EEGs, and learn how the results are applied in clinical decisions.
    • Curriculum: One day will be spent under the supervison of an EEG technologist observing how to apply electrodes and run the recorder. Three afternoons per week will be spent reviewing EEGs with the fellows and attendings. A copy of the EEG chapter from Baker and Baker Neurology (this is no longer copyrighted) will be provided on the first day.
  2. Learn to take care of patients with epilepsy.
    • Benchmark: Understand the different causes and treatments for epilepsy. How does epilepsy affect the daily lives of this population? .
    • Curriculum: One half-day per week will be spent in clinic seeing patients. Most of the experience in clinic will be shadowing attendings. You will join the inpatient team on daily morning rounds. A selection of relevant textbooks will be available for borrowing.
  3. Epilepsy conference presentation.
    • Benchmark: Each week the epilepsy neurologists and neurosurgeons get together to discuss patients. The student will understand the general reasons to choose medical vs. surgical therapy.
    • Curriculum: Present one patient at epilepsy conference, and participate in case management discussion. The specific case to be presented will be selected by the inpatient epilepsy attending.
  4. Inpatient monitoring.
    • Benchmark: Understand the reasons for admitting patients for long-term monitoring.
    • Curriculum: Join rounds every morning. Admit and follow at least one patient at a time and write daily progress notes.

Absentee policy: This clerkship can be taken for 2 weeks or 4 weeks. For a 2-week clerkship, you are expected to attend every day. In the event of an urgent situation necessitating an absence, you must discuss this with your preceptor in advance, if possible. For a 4-week clerkship, please see Absentee/Work Hours Policies in menu at left.

Mini-CEX: No requirement.

Patient log: No requirement.

Pocket syllabus: None

Student evaluation: Discussed at site.

Course evaluations: Discussed at site.

Final exam: No requirement.

Grading policy: The 4-week elective is eligible for H/HP/P/F.  The 2-week elective is only P/F.

Contact information: See corresponding tab.