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BIDMC – Neurology Fellowship: Adult EEG/Epilepsy

Adult EEG/Epilepsy

Epilepsy1The Comprehensive Epilepsy Clinic at Beth Israel Deaconess Medical Center was established in 1983, is designated as a Level 4 Epilepsy Center by the National Association of Epilepsy Centers (NAEC) as a program offering the highest level care for people with epilepsy.  The division has a longstanding history of providing excellent care for patients with epilepsy and, currently, we evaluate and treat the largest population of adult patients with epilepsy in all of New England. Our multi-disciplinary team is made up of epileptologists, a principal neurosurgeon, psychiatrists, neuroradiologists, clinical epilepsy nurses, clinical neuropsychologists, clinical social workers, neurodiagnostic technologists, neuroengineers and research associates.  Furthermore, we offer a New Onset Seizure Clinic, providing comprehensive diagnosis and treatment for adolescents (16+ years) and adults who have recently begun having seizures or seizure-like episodes. We will arrange for an appointment with one of our physicians within the first week of referral and often within 24-48 hours.

The center offers 24 hour-a-day, 7 day-a-week coverage with the following capabilities:

Full range of diagnostic testing
Routine and sleep-deprived EEG
High density (256 channel) EEG with source localization
Ambulatory EEG with or without video monitoring
Inpatient video-EEG monitoring
Continuous video-EEG monitoring in intensive care
3T MRI
PET (Positron Emission Tomography)
SPECT (Single Photon Emission Tomography)
Comprehensive Neuropsychological testing
Wada test for localization of language and memory in presurgical candidates

Expertise in epilepsy management

      • Women’s Health in Epilepsy Clinic
        New Onset Seizure Clinic
        Vagal nerve stimulator
        Management of intractable epilepsy
        Epilepsy surgery
        Treatment of status epilepticus
        Evaluation / management of mood and cognitive comorbidities
        Dietary therapies, including the Modified Atkins Diet
        Noninvasive brain stimulation
        Access to clinical trials of new antiseizure medications and other therapies

      Current epileptologists on staff, who also hold faculty positions at Harvard Medical School:

  • Bernard Chang, MD, Chief, Division of Epilepsy
  • Donald Schomer, MD, Director, EEG Laboratory
  • Frank Drislane, MD
  • Walter Heine, MD
  • Daniel Goldenholz, MD, PhD
  • Dr. Phillip Larimer, MD, PhD
  • Monica Makhija, MD
  • Mouhsin Shafi, MD, PhD
  • Trudy Pang, MD
  • Volney Sheen, MD, PhD

Historically:

      • First center worldwide to use SPECT measurements
      • First center to develop and implement 128 channel EEG technology for the evaluation of patients for epilepsy surgery
      • First program to introduce Lamictal as an experimental drug for the treatment of epilepsy into the United States.
      • First center to implement using home-video linked to EEG to evaluate patients in the home environment
      • Early in the evaluation of seizures and cognition using microwires as part of the evaluation in patients undergoing epilepsy surgical evaluations that required invasive EEG techniques. These studies were in collaboration with basic scientists at MIT and MGH
      • Major center studying the reciprocal relationships between epilepsy and endocrinological abnormalities.
      • One of the first centers to provide initial studies of Trileptal, Tiagabine, the Vagal Nerve Stimulator (VNS).
      • Instrumental in assessing the utility of MEG in Epilepsy.

Epilepsy Research
Historically, the Department of Neurology at BIMDC has created a strong foundation in epilepsy research. Our department was the first clinical program to do both symptomatic and asymptomatic SPECT scans in epilepsy patients, as well as the first program to carry out a computer based/digital multichannel intracranial EEG monitoring. We have longstanding efforts in the assessment of new treatment techniques as the first program to introduce Lamictal as an experimental drug for the treatment of epilepsy into the United States. We have been actively involved in early phase trials on many drugs as well as devices used to treat people with epilepsy.   Additionally, our investigators have worked across the Greater Boston Community, with National and International collaborators on numerous clinical and research projects.

We continue to contribute to both clinical and basic science research in epilepsy in the following areas:

      • Clinical trials of antiepileptic medications and other therapies
      • Developmental disorders of the central nervous system
      • Genetics and Ion channel physiology
      • Inherited disorders of cortical development
      • Investigation of ICU patients in Status Epilepticus
      • Noninvasive brain stimulation as an approach to treatment
      • Studies of malformations of the cerebral cortex
      • Use of high density EEG and individualized 3D renditions for epileptic source localization

Our Investigators Include:
Dr. Matthew Anderson
Dr. Bernard Chang
Dr. Phillip Larimer
Dr. Trudy Pang
Dr. Steven Schachter
Dr. Mouhsin Shafi
Dr. Volney Sheen

Clinical Neurophysiology/Epilepsy Fellowship:
The program began in 1984 with Dr. Steven Schachter and there have been up to 3 fellows each year since then. Additionally, there have been multiple doctoral sabbatical trainees, numerous Harvard Neurology Training Program residents and visiting neurology residents, several Harvard Medical School honors students and an undergraduate Harvard Psychology honors student through this program. The more formal program is acknowledged by the American Clinical Neurophysiology Society as an official training site for Electroencephalographers.

As one of the first centers to receive ACGME accreditation, we are now approved through the AMA subsection for fellowship training programs of the ACGME in conjunction with Children’s Hospital. Therefore, this one year fellowship is integrated with the Children’s Hospital program to provide a broad exposure to pediatric and adult clinical neurophysiology and to clinical epilepsy. Major rotations include: Epilepsy Monitoring Unit, continuous EEG monitoring in the ICU/Epilepsy inpatient consult, outpatient epilepsy clinic, and elective rotations in with elective rotations in clinical neuromuscular disease EMG/NCS,  sleep, autonomic neurophysiology, and intraoperative monitoring; at Children’s Hospital, Beth Israel Deaconess Medical Center, and Massachusetts General Hospital. There are weekly didactic lectures in the above subspecialties. Fellows may choose to do a second year of fellowship in epilepsy.

Furthermore, our clinical neurophysiologists and epileptologists are very active in both clinical and basic science research from an epilepsy perspective, which provides ample opportunity for fellows to become involved in epilepsy related research projects.

All interested individuals must have completed an ACGME-accredited training program in either pediatric or adult neurology or a program in one of these specialties that is located in Canada and accredited by the RCPSC.  Selected fellows will spend 1-2 years developing subspecialty expertise in clinical neurophysiology and epilepsy.

Trudy Pang, MD
Director, Clinical Neurophysiology Fellowship and Adult Epilepsy Fellowship
Beth Israel Deaconess Medical Center
330 Brookline Avenue
Boston, MA 02215

tpang@bidmc.harvard.edu