The Epilepsy Fellowship is a one-year program (with the option of a second year Clinical Neurophysiology Fellowship – see below). The Fellowship offers specialized training in neonatal, pediatric, and adult epilepsy and neurophysiology – with an emphasis on the management of intractable epilepsy and epilepsy surgery evaluation. Fellows can select between an adult or pediatric-focused track. Regardless of track, exposure is offered to both adult and pediatric patients and expert faculty.
All fellows attend a combined weekly epilepsy surgery conference, and a comprehensive lecture series throughout the year covering pediatric and adult topics, plus journal club and EEG review sessions. Fellows will become knowledgeable of the various imaging modalities involved in the evaluation of intractable epilepsy, including MRI, interictal/ictal SPECT, PET, and fMRI. Additionally, the Epilepsy Fellowship provides hands-on experience and intensive individual training by faculty in the following procedures and clinical activities:
- Pharmacology of antiepileptic drugs
- Investigational antiepileptic drug research
- Outpatient subspecialty epilepsy clinic
- Routine and intraoperative evoked potentials
- Scalp electroencephalography in neonates, children, and adults
- Video EEG monitoring in an epilepsy monitoring unit
- Invasive electroencephalography with depth and subdural electrodes
- Intraoperative electrocorticography and cortical mapping in awake or anesthetized patients
- Extraoperative cortical mapping
- Use of the vagus nerve stimulator and responsive neurostimulation
- Wada testing
Fellows rotate through the adult UT Southwestern Epilepsy Program and the pediatric Children's Epilepsy Center. Both centers are Level 4 NEAC Epilepsy Centers with active surgical programs. Faculty includes five pediatric and four adult epileptologists.
Fellows in the pediatric track are based at Children’s where there is an eight-bed Epilepsy Monitoring Unit which admits 600 patients yearly for video-EEG monitoring. The pediatric Neurophysiology Laboratory performs more than 3,500 EEGs and evoked potential studies annually. The Comprehensive Epilepsy Center has 7,000 outpatient pediatric epilepsy clinic visits per year and includes multidisciplinary clinics for the ketogenic diet, epilepsy surgery, and genetic syndromes programs.
Fellows in the adult track spend time at Parkland Memorial Hospital and Zale Lipshy University Hospital (a neuroscience specialty hospital). The Epilepsy Monitoring Unit has 11 beds and admits 500 patients annually. The associated Neurophysiology Labs provide outpatient and inpatient services to more than 1,100 beds within the affiliated sites of the UT Southwestern Medical Center. Outpatient experience is offered at the adjacent Neurology Clinic at the James W. Aston Ambulatory Care Center.
Those successfully completing the program are eligible for subspecialty certification in Epilepsy by the American Board of Psychiatry and Neurology. An optional second year of fellowship training in Clinical Neurophysiology is also available. This combined two-year fellowship program prepares candidates for an academic practice in a tertiary epilepsy center, offering a greater opportunity to become proficient at corticography, invasive monitoring, and cortical mapping procedures. Additionally, second-year fellows are expected to complete an independent research project for presentation at a national meeting and publication.
Applications are generally accepted 24 months prior to the anticipated start of training. This is typically in August of the PGY-3 year for Adult Neurology Residents, or PGY-4 year for Pediatric Neurology Residents. Interviews typically occur thereafter in the fall/winter.