Goals

We are highly committed to training diverse and enthusiastic fellows to become exceptional epileptolologists. In addition to gaining knowledge and practical skills in the most complex care available for people with seizures, our graduates will be prepared to aid underserved populations, participate in quality improvement and clinical research projects to enhance the care available to people with seizures, shape health polices as patient advocates, and balance their professional and personal lives to find meaning and joy.

Learning Environment

The Ayer Neuroscience Hartford HealthCare Epilepsy Center is comprised of 8 clinics located across the state of Connecticut, and the NAEC accredited level 4 Epilepsy Monitoring Unit (EMU) located at Hartford Hospital. The Epilepsy Monitoring Unit serves patients from all 8 epilepsy clinics, as well as outside referrals. Hartford Hospital presurgical procedures include PET, SPECT, MRI, fMRI and Wada testing. MEG studies are performed in collaboration with MGH. We perform intracranial EEG studies, using both stereo-EEG and subdural grid methodology, and utilize extra-operative cortical mapping. We also offer neuro modulation treatments such as the responsive neurostimulation (RNS)system, Vagal nerve stimulator (VNS) and deep brain stimulation (DBS).

The Hartford Hospital Epilepsy Center is staffed by 10 epileptologists representing a wide range of training backgrounds and 2 neurosurgeons with extensive epilepsy experience. In addition, the center is strengthened by 2 neuropsychologists, 3 APPs, a clinic nurse, a neuroscience pharmacist, and an Epilepsy Center–specific social worker. We collaborate with a psychiatrist with special interest in epilepsy.

Hartford HealthCare includes 7 inpatient hospitals within Connecticut with 24/7 EEG capability. Continuous EEGs (cEEG) are performed at 3 of the hospitals. Hartford hospital is home to a high-volume dedicated neuroscience ICU. We work closely with our outstanding neuro-intensivist colleagues to care for critically ill people on cEEG.

The integrated digital environment enables the fellow to access EEGs from all clinical sites right from their primary computer. In this way they can serve our patients, and gain experience from the full breadth of our clinical enterprise, without having to travel all over the state.

The Epilepsy Center at Connecticut Children’s is the training site for pediatric and neonatal EEG/epilepsy as well as dietary treatments for refractory epilepsy.

The epilepsy center at UConn is staffed by 4 epileptologists and offers outpatient epilepsy clinics, adult epilepsy monitoring unit, inpatient cEEG and outpatient ambulatory EEG monitoring services. A high-density EEG (hdEEG) is available for use for both clinical and research endeavors.

Curriculum

1. Medical management of epilepsy patients - Inpatient management of complex epilepsy patients in the Epilepsy Monitoring Unit. Longitudinal outpatient clinic one half day a week. Specialty clinic opportunities such as epilepsy in women, dietary treatments of epilepsy, and genetics are available.
2. Scalp EEG interpretation - Fellows gain proficiency in the technological aspects and interpretation of:
   • Routine EEG
   • Ambulatory EEG
   • Long-term EEG on the critical care epilepsy service
   • Presurgical and diagnostic video EEG in the epilepsy monitoring unit
3. Surgical management of epilepsy patients - Fellows will participate in comprehensive presurgical diagnostic evaluations involving quantified SPECT and PET, fMRI, MEG, Wada test as well as intracranial EEG monitoring utilizing stereo EEG, subdural grids and strips, and cortical mapping. We offer training in neurostimulation devices such as RNS, VNS, and DBS.
4. Research - Fellows are encouraged to select research and quality improvement projects and other scholarly projects under the mentorship of supervising faculty.

At the conclusion of training, the fellow will be eligible for the ABPN Epilepsy board exam.

Rotation Schedule

Fellows will spend at least 6 months at Hartford Hospital, up to 3 months at UConn John Dempsey hospital, and 1 month at CT children’s medical center. While rotating at Hartford Hospital, fellows will rotate through the EMU and the cEEG service. Fellows will participate in outpatient clinic one half day a week at the largest clinic attached to Hartford Hospital. There is one-month elective in a specialty area of the fellow’s choice or to pursue research endeavors.

Didactics

Our comprehensive didactics includes a longitudinal epilepsy lecture series, refractory epilepsy conference, journal club, and complex EEG review conferences.

External speakers provide neuroscience and epilepsy Grand Rounds.

Attendance at the American Epilepsy Society annual meeting is expected, and presenting at national conferences is encouraged. Our fellows are welcome to participate in national and regional seminars and courses such as J. Kiffin Penry Epilepsy Mini Fellowship, stereo-EEG courses, and clinical courses connected to national conferences such as AES AAN, and ACNS.