Clinical Neurophysiology Rotation
The rotation in the laboratories of EEG and Clinical Neurophysiology of the University of Washington Medical Center and Harborview Medical Center provides excellent exposure to state-of-the-art clinical neurophysiology. These two laboratories produce approximately 5,000 studies per year, including such special tests as continuous ICU EEG monitoring, long-term video EEG monitoring of patients with uncontrolled epilepsy and other episodes evaluated for diagnosis or possible neurosurgical treatment, neonatal recordings, monitoring with subdural and depth electrodes, and electrocorticographic recordings during surgery for epilepsy. The epilepsy monitoring unit at Harborview has ten monitoring beds, and serves the Regional Epilepsy Center which has approximately 5,000 outpatient visits, and performs more than 50 resective neurosurgical procedures to treat epilepsy each year. In addition, the labs performs many other types of studies, including all modalities of evoked potential tests, intraoperative evoked potential monitoring, and specialized autonomic testing. The neuropsychology service for the hospitals is part of the Regional Epilepsy Center, and experience in learning the interpretation of neuropsychological test batteries is available.
During the first two to three weeks the residents are introduced to the techniques of patient preparation and to EEG and evoked potential instrumentation. Direct participation is encouraged including the actual recording of EEG's and evoked potentials. At the same time, the staff electroencephalographers who conduct or supervise reading sessions daily gradually develop the residents’ interpretive skills. The goal of this rotation is to help the residents develop basic knowledge of clinical electrophysiologic techniques and their clinical usefulness and limitations. One day per week is spent in the Epilepsy Clinic, evaluating new and follow up patients with Epilepsy. Residents also attend daily rounds of the inpatient epilepsy monitoring service, and are responsible for admissions and daily patient management while on service. Following their EEG rotation, the residents are encouraged to continue to review their own records obtained on their patients and to discuss them with the staff electroencephalographers. Additional elective time further strengthens the residents' knowledge of clinical electrophysiology. The Children's Hospital and Regional Medical Center also has an extensive epilepsy program. Approximately 1800 EEG's are done each year. There are four monitored beds for 24-hour CCTV recordings. The faculty works closely with many departments in a growing epilepsy surgery program. Residents are instructed in pediatric recordings during their three-month pediatric ward rotation and are encouraged to spend elective time if interested in further exposure.
Dr. Shahin Hakimian (