|
The fellowship begins with a two-month Clinical Neurophysiology
Introductory Course covering all areas of clinical neurophysiology.
The anatomy, physiology, pathophysiology and clinical neurophysiological
features of disease are emphasized, along with the technical aspects
of testing methods.
Clinical Training
During the subsequent months you will alternate rotations in the
EEG laboratory and epilepsy services.
EEG: During the time spent in the EEG lab, you will interpret a
large number of EEG records from adults and children with a wide
variety of disorders. During the subsequent months in EEG, you will
be given increasingly independent responsibility to oversee complex
problems, take emergency call, oversee and perform prolonged EEG
and surgical monitoring, learn about evoked potentials, teach new
residents, and present lectures and seminars.
There is a strong emphasis on EEG of seizure disorders. You will
be exposed to a variety of seizure problems, the monitoring techniques
used to evaluate patients with seizure disorders (including prolonged
monitoring and ambulatory monitoring), and techniques used for recording
during surgery. You will also see and interpret EEGs with a wide
variety of other patterns during the EEG rotation.
During the fellowship, you will have the opportunity to rotate
to the EMG or sleep labs to get a broad experience in clinical neurophysiology.
Epilepsy: During the time spent on the epilepsy service, you will
take care of patients on the inpatient epilepsy monitoring service,
see patients in the epilepsy outpatient clinic, and see patients
on the hospital epilepsy consulting service.
The schedule of clinical activities is designed to achieve a balance
between outpatient and inpatient care, and to ensure that you have
experience with different aspects of epilepsy care. You will work
with both adult and pediatric patients, and will be involved with
drug therapy and/or surgical treatment for new-onset seizures or
for refractory epilepsy. You also will participate in:
- Drug trials
- Intraoperative monitoring
- Video-digital EEG recordings
The rotations are designed so you will have gradually increasing
responsibilities in these areas. By the end of your fellowship,
you should be able to perform these activities independently.
Didactic Training
Clinical conferences, lectures, lecture-demonstrations, seminars,
small discussion groups, and one-on-one instruction are all an integral
part of Mayo Clinic's clinical neurophysiology programs. You will
have the opportunity to attend weekly conferences in both the EEG
and EMG laboratories.
These conferences include clinical EEG and EMG case reports, lectures
and lecture-demonstrations about:
- Electronics and instrumentation
- Evoked potential studies
- Autonomic function studies
- Basic neurophysiology
You also may attend weekly seminars and conferences in neurology,
neuropathology and pediatric neurology
During your clinical neurophysiology fellowship, you will participate
in a series of formal didactic sessions and regularly scheduled
conferences in all aspects of clinical neurophysiology. There are
regular conferences in EEG, EMG epilepsy, neuromuscular and peripheral
nerve disorders, movement disorders and sleep disorders. Opportunities
for teaching and research also are available.
Research Training
Regardless of the fellowship you select, you are encouraged to complete
at least one investigative project during your training. The type
of research project you select will depend on your interests and
capabilities and the time available in your program. Opportunities
are available for collaborative studies with other clinical and
basic science sections at Mayo Clinic.
When you complete your research, you will be expected to present
it at a scientific meeting or prepare it for publication in a scientific
journal. This experience teaches you how to comprehend and critically
evaluate other reported investigations and gain insight into the
conduct and principles of research.
Additional Training
Evoked Potentials
You will have the opportunity to study in Mayo Clinic's EMG laboratory
learning about the techniques and interpretation of evoked potential
studies. This includes exposure to:
- Brainstem auditory evoked responses
- Pattern reversal visual evoked responses
- Somatosensory evoked potentials
Movement Disorders
In Mayo Clinic's EEG and EMG laboratories, you also can learn about
techniques for assessing movement disorders - including tremors,
myoclonus, seizures, botulinum injections and others.
Sleep Disorders Center
The Mayo Clinic Sleep Disorders Center is a multidisciplinary center
staffed by consultants in pulmonary medicine, neurology and psychiatry.
If you enroll in the two-year program, you may spend time in the
center, gaining experience in performing and interpreting nocturnal
polysomnography and multiple sleep latency tests. Here, you also
have the opportunity to see patients with a wide variety of sleep
disorders, including:
- Narcolepsy
- Sleep apnea syndrome
- Parasomnia
- Insomnia
A separate one-year fellowship in sleep disorders medicine also
is available, which fulfills training requirements for certification
by the American Board of Sleep Medicine.
Also see:
Pediatric Epilepsy
The Mayo Clinic Pediatric Epilepsy Fellowship is designed
for individuals who have one year of EEG/Clinical Neurophysiology
training. The one-year fellowship is equally divided into clinical
and research training. The clinical training includes outpatient
pediatric epilepsy clinic and inpatient video EEG monitoring.
You will gain experience in presurgical evaluation including MRI,
MRS, ictal & interictal SPECT, PET, extra-operative electrocorticography
and functional mapping, as well as the ketogenic diet and use of
the vagus nerve stimulator. Opportunities for epilepsy related research
include epidemiology, genetics, clinical electrophysiology and behavior.
Individuals who have not had a year of clinical neurophysiology
will also be considered.
Also see:
Autonomic Laboratory
If you would like experience in the autonomic laboratories, you
can arrange a time in these areas before or after completing your
clinical neurophysiology fellowship. This three-month experience
includes lectures, supervised reading, training in autonomic testing,
and possibly a research project under the supervision of staff.
Mayo Clinic's autonomic laboratory has three clinical components:
- Clinical autonomic laboratory
- Research and development autonomic laboratory
- Thermoregulatory laboratory
Routine tests performed in the clinical autonomic reflex laboratories
include:
- QSART (quantitative sudomotor axon reflex test)
- Orthostatic BP and HR response to tilt
- Heart rate (HR) and response to deep breathing
(HRDB)
- The valsalva ratio (VR)
- Beat-to-beat BP (BPBB) to valsalva maneuver,
tilt and deep breathing
- Salivation test
- Tests to detect sympathetically maintained pain
or reflex sympathetic dystrophy (RSD)
- Telethermography or infrared thermometry
- Resting sweat output
- QSART
- Thermoregulatory sweat test
|
