Pediatric Headache Medicine
The UT Southwestern Pediatric Headache Fellowship is accredited by the Texas Medical Board (TMB) and the United Council for Neurological Subspecialties (UCNS) and centered at Children’s Health Dallas. Children's is a private, nonprofit, tertiary-care pediatric hospital and Level I trauma center that is the primary pediatric teaching hospital for UT Southwestern.
Fellows gain extensive exposure and clinical skills pertaining to all aspects of headache medicine including procedures, as well as diagnostic and outpatient clinics with advanced diagnostic capabilities including urgent same-day treatments.
The fellowship is supported by an exceptionally diverse academic Pediatric and Adult faculty from UTSW which includes UCNS-certified Headache Medicine clinicians from Neurology and Pain Management, Neurosurgery, Maxillofacial Surgery, Autonomic Disorders, Sports Neurology, Neuro-ophthalmology, Neuropsychology, Rehabilitative Medicine and Sports Neurology.
We follow the curriculum proposed by United Council of Neurological Subspecialties and provide clinical and didactic training to prepare the trainee to successfully master material required for UCNS Headache specialty board achievement. In addition, academic Research and manuscript preparation are strongly supported and encouraged with many opportunities in basic science or clinically-focused projects.
The fellowship also offers a Headache Medicine/Concussion and Sports Neurology track for interested trainees with curriculum and training with Sports Medicine, advanced training in exercise physiology and “return to play” protocols, athletic trainer “on field” sports triage with a close working relationship with advanced Neuroimaging and other researchers.
• A strong academic component supported by affiliations in Pediatrics, Pain Management and Neurology
• Dynamic and supportive Child and Adult Neurology and Anesthesia Residency Programs that provide inpatient and overnight call coverage, and additional opportunities for educational opportunities and training
• Responsibility for comprehensive patient care including a diverse age range and diagnostic comprehensive workup and treatment of patients with headache from primary and secondary causes, cranial neuralgias and cervicalgia
• Active involvement in performing pediatric interventional procedures including lumbar punctures with manometry, chemodenervation with onabotulinum toxin A (Botox®), and trigger point and peripheral nerve blocks
• Heavy exposure to post-traumatic headache and concussion patient management including objective concussion assessments in a busy Concussion Program.
Beyond the clinical experience
In addition to clinical activities, fellows are trained in the basic principles of research methodology, manuscript preparation, and other activities essential to an academic career and to objective interpretation of current literature and clinical guidelines in a private practice setting. The fellowship provides clinical and didactic training to prepare the trainee to successfully master material required for UCNS Headache specialty board achievement.
Reading assignments, skills workshops, symposia, didactic, clinical and journal club conferences will provide in-depth exposure to the clinical variety of headache-related disorders found in the International Classification of Headache Disorders (ICHD-3), important clinical trials and published material relevant to the study of headache. These efforts are supplemented by attendance at multidisciplinary conferences, a regularly scheduled journal club, and interdisciplinary conferences, such as those related to intracranial pressure disorders and concussion.
Fellows are provided with dedicated academic time to pursue their academic interests under direct supervision of the fellowship faculty. Up to one month of elective time is provided and additional adult-focused clinical rotations are incorporated into the rotational schedule with affiliated adult institutions and as allowable by the receiving service(s). Fellows are entitled to an academic enrichment fund to support educational materials and attendance to scientific meetings.
At this time, there are no nighttime or weekend call responsibilities. Day time call coverage for inpatient and referring providers is required on a rotational basis.
Facilities and Equipment
Children’s newly opened specialty care center at Cityville houses the outpatient Headache Clinic. The pediatric outpatient headache clinic and treatment center was specifically designed to enhance the learning experience for the fellow with state of the art media, workspaces, procedure rooms, and conference center with web-ex. Diagnostic equipment includes panoptic ophthalmoscopes with retinal imaging, B mode ultrasound for optic nerve sheath diameter measurements, Transcranial Doppler Ultrasound , computerized posturography and IMPACT Neurocognitive testing.
In addition, a headache-trained medical care team including faculty, nursing, care coordinators, social work, nutrition, and Advanced Care Practitioners support the fellow with clinical work. The clinic is located adjacent to a Pediatric Neurorehabilitation center equipped with mobility equipment from Switzerland, a specialized aquatic center, vestibular and visual “post-concussive” recovery equipment. The Rehabilitation Center is staffed by experienced occupational, physical and aquatic therapists who provide treatment approaches emphasizing, “whole body” craniofacial, cervical, myofascial and autonomic associated treatments to aid in recovery from headache and facial pain disorders. It is important to have the fellow exposed to inpatient diagnosis and treatment of headache disorders which are often associated with “secondary causes” for headache and treatment of refractory primary headache disorders (i.e. “status migranosus).
Inpatient headache consultation will be provided to support the Pediatric Neurology inpatient service and takes place at Children’s Medical Center Dallas, located in the Southwestern Medical District in the heart of Dallas. Children’s Medical Center Dallas is home to the only academic healthcare system in North Texas that is dedicated exclusively to the comprehensive care of children from birth to age 18. Children’s Health is one of the top pediatric hospitals in the country and the fifth largest healthcare provider in the nation. Children’s Medical Center Dallas provides more than 360,000 patient visits each year and is equipped with 487 inpatient beds which include 24 medical/surgical, 65 critical care, more than 50 outpatient specialty centers, a state-of-the-art emergency center and a 12-bed psych unit.
Joint Pediatric and Adult Headache Academic conference is held weekly throughout the year and includes both didactic lectures and case-based presentations. Fellows present at this conference, at select resident and student case conferences, and at Neurology Research Days. Fellows are encouraged to present at regional or national conferences. Other available conferences include (and may vary depending on block rotation and track): Neuroradiology, Pediatric Neurology core lecture series, vascular disorders, concussion conference, intracranial pressure disorder conference, yearly “Pediatric and Adult Neurology update” multiday symposiums, Sports Medicine and a highly interactive Fellows Core Curriculum Research series. Separate Pediatric and Neurology Grand Round are held weekly with prestigious visiting and local professors, offering the opportunity to meet and learn from leading national authorities on a variety of topics.
Intellectual vibrancy and technological innovation are core values of the department, which are developed through collaborative efforts involving clinical and research faculty and staff. Fellows have ready access to UT Southwestern's Health Sciences Digital Library and Learning Center, only five minutes away, and most journals can be accessed online from Children's Medical Center Dallas. Texts are also available for sign-out and review. Fellows have the opportunity to attend a major headache related meeting, preferably as a presenter. There are a variety of ongoing institutional and pharmaceutical research studies in Headache treatment and post-traumatic headache that the fellow has the opportunity to participate in (as available).
The program provides a one-year fellowship position each year. Traditionally, applicants have completed an adult or child neurology residency, but other residency trained practitioners may apply. Applicants should email a copy of their CV, indicate the academic year they are interested in applying for to Dr. Tonia Sabo or Stephanie Lindsey, Pediatric Headache Fellowship Coordinator.