NeuroLogic: Epilepsy Rotation
Epilepsy Rotation Internal Survival Guide (July 2026)Created by Ji Yeoun (Jenna) Yoo, MD, Epilepsy Fellowship Program Director
Educational Goals & Objectives
Patient Care & Procedural Skills
Trainees are expected to demonstrate competence in:
- Diagnostic evaluation, medical management, and surgical evaluation of epilepsy patients
- Interviewing and examining patients with epilepsy and seizures
- Differential diagnosis of various clinical presentations
- Appropriate medical/surgical investigations (lab, pathologic, radiologic, neurophysiologic)
- Inpatient and outpatient management (medical and surgical)
- Working in multidisciplinary teams
Medical Knowledge
Trainees are expected to demonstrate competence in knowledge of:
- Basic science, genetics, and epidemiology of epilepsy
- Neuroimaging and diagnostic modalities
- Neuropsychology
- Pharmacologic and non-pharmacologic treatments
- Comorbidities in epilepsy
- Ictal/interictal EEG patterns and prognosis
Other Competencies
- Practice-based Learning: Analyze practice using quality improvement methods; assimilate evidence from scientific studies.
- Interpersonal Skills: effective exchange of information with patients, families, and professionals.
- Professionalism: Commitment to professional responsibilities and ethical principles.
- Systems-based Practice: Awareness of the larger health care system and resource utilization.
Site-Specific Goals
| Site | Focus & Description |
|---|---|
| Mount Sinai Hospital (MSH) | Includes Kravis Children's Hospital. Focus on long-term EEG monitoring/interpretation for EMU and ICU patients, overall epilepsy care, pediatric epilepsy, and pediatric epilepsy surgery. |
| Mount Sinai West (MSW) | Focus on adult epilepsy surgery, outpatient/ambulatory EEGs. Training includes intracranial EEGs for adult surgery, cortical mapping, and outpatient care. |
When to Communicate
Trainees MUST communicate with the supervising attending or fellow if:
- Patient is admitted to the Epilepsy Monitoring Unit (EMU)
- Patient is admitted to the Neuroscience ICU
- Patient is undergoing epilepsy surgery
- There is a significant change or worsening of clinical status
Epilepsy Team Contact List
(Refer to the full PDF/document for phone numbers and emails)
EMU Attendings
- Leah Blank, MD
- Matthew Davitz, MD
- Madeline Fields, MD
- Gena Ghearing, MD
- Kia Gilani, MD
- Shu-wei Hsu, MD
- Kyusang Lee, MD
- Lara Marcuse, MD
- Maite La Vega-Talbott, MD
- Sonam Verma, MD
- James "Jake" Young, MD
- Ji Yeoun ("Jenna") Yoo, MD
Support Team
- NPs: Dina Bolden (MSW Inpatient), Vincent Palmieri (MSH Outpatient), Soka Yu (MSW Outpatient), Timothy Bell (Kravis Inpatient)
- EMU Coordinators: Nadia Gabriel, Toni Kavanaugh (Peds)
- Neurosurgeons: Saadi Ghatan, MD, Ted Panov, MD, Peter Morgenstern, MD
- Tech Managers: Roxanne Isom (MSW)
- Neuropsychologists: Adam Saad, Sloane Sheldon
- Neuroradiologist: Brad Delman
- Psychiatrist: Pojen Deng
- Admin Assistants: Stephanie Cole, Melissa Sebastian, Amanda Perez
- Research: Onome Eka, Kevin Van Geem
- Social Worker: Ilona Silva Alvarez
Important Internal Extensions
| MSH 8W Front Desk | x45558 (212-241-5558) |
| MSH EMU Monitor Watcher | x45039 (212-241-5039) |
| MSH NSICU | x42100 (212-241-2100) |
| NEMAT | x46467 (212-241-6467) |
| Help Desk | 212-241-HELP |
Pre-Fellowship Checklist
- VPN Access established
- Hospital DEA number obtained & linked to VPN
- Cognisent app (NotifyMD) set up (Coordinator to email Yvette Lopez)
- Natus and Citrix Access (Coordinator to email Pepi Dakov)
- EPIC Access to clinics (Call helpdesk 212-241-4357, add EPIC ID 8530012 [HOSP NEURO SEIZURE])
- Teams App installed
- Imprivata setup
- Added to EPIC chat groups
General Resources
- Call Schedule: www.amion.com (pwd: msneuro)
- Paging: x41300 (212-241-1300) or via Amion
- EEG Citrix Access: msvpn.mountsinai.org
IT & Natus Issues
To Open a Ticket for Natus Issues:
- Email:
[email protected]AND[email protected] - Assignment Group: XLTEK
- Include: Problem, Screenshots, Workstation Name/IP (e.g., MSN REV01), Building/Room #, Contact info.
- Call: 212-241-HELP (Get a ticket number)
EEG Laboratories
- MSH: Annenberg 2nd floor – Neurology Practices Area
- MSW: 4th floor
- Hours: Mon-Fri 8am – 4pm
Fellows/Residents are encouraged to observe hookups and perform layouts early in training (July/Aug).
Residents: Inpatient Rotation (MSH & MSW EMU)
AM Workflow (~7am - 12pm)
| Time | Activity |
|---|---|
| 7:00-8:00 AM | Arrive and pre-round on patients (EMU and epilepsy consults). |
| 8:00-9:00 AM | Attend Morning Report. |
| 9:00-10:00 AM | Read at least one LTM EEG (Week 1: EMU study, Week 2: EMU + ICU study) and draft reports. Continue following until monitoring ends. |
| 10:00-12:00 PM | Round with Epilepsy Fellow/Attending. |
PM Workflow (12pm - 5pm)
| Time | Activity |
|---|---|
| 12:00-1:00 PM | Neurology Noon Conference (MSH). |
| 1:00-5:00 PM |
|
Residents: Outpatient Rotation
MSH Amb EEG/Outpatient (PGY-2)
- 8-9 AM: Morning Report
- AM: Epilepsy Clinic OR EEG Reading (review 1 LTM with team).
- PM: Resident Continuity Clinic OR Faculty Clinic. Ambulatory EEG reading with attending.
MSW Outpatient (PGY-2)
- AM: Epilepsy Clinic (if no clinic, self-study EEG reading).
- PM: Ambulatory EEG readings with block attending.
- Note: One afternoon is Continuity Clinic.
Clinic Schedule (Sample)
| Day | AM (9-1) | PM (1-5) |
|---|---|---|
| Mon | Ghearing (MSH) | Resident Clinic / Reading |
| Tue | Blank (MSH) / Fields (MSW) | Reading / Afternoon Rounds (2-4 PM) |
| Wed | Yoo (MSH) | MDC Conf (4-5:30) / Didactics |
| Thu | Ghearing (MSH) / Marcuse (MSW) | Reading / Clinic |
| Fri | Yoo (MSH) | Didactics |
Teaching Rounds
| Event | Time | Description |
|---|---|---|
| Epilepsy Surgery Conf | Wed 4-5:30 PM | Mandatory. Case presentations & surgical planning. |
| Teaching Rounds | Wed 1-2 PM |
Week 1: ICU EEG Week 2/3: Faculty Lectures Week 4: Journal Club |
| EEG Conf (Biweekly) | Mon 12:30-1:30 | Interesting cases. |
| Grand Rounds | Fri 8-9 AM | Neurology Grand Rounds. |
| Resident EEG Conf | Fri 12-1 PM (Biweekly) | Attending/Fellow reviews interesting block cases. |
Milestones & Resources
Fellows: Inpatient Rotation
Locations: MSH 8West (4 beds) & MSW 8B (4 beds).
Daily Routine
| Time | Activity |
|---|---|
| AM (7-8) | Start reading LTM EEGs (Expert tip: start with ICU studies). Prepare prelim reports. |
| AM (9-10) | Rounding with Attending. Finalize reports, communicate with primary teams (use '2HELPS2B' score). |
| PM |
|
EMU Admissions & Consults
- Admissions: Write H&P, place orders. Check elective calendar with Coordinator.
- Consults: See consults from NSICU/Gen Neuro. Supervise resident consults. (Weekends: e-consult or brief note).
Outpatient Clinic (During Inpatient Block)
- MSH Rotation: Friday PM (Continuity Clinic with Dr. Muxfeldt).
- MSW Rotation: Tue PM (Dr. Marcuse), Thu PM (Dr. Fields).
Fellows: Outpatient Rotation
Ambulatory Block
- AM: MSH Clinics (Tue: Blank, Thu: Ghearing, Fri: Yoo).
- PM: Read outpatient routine & ambulatory EEGs (MSH, MSW, MSM, MSQ). Round with Attending.
Elective Block
- Two MSW AM clinics/week (Tue: Marcuse, Fri: Fields).
Clinic Schedule
| Day | AM | PM |
|---|---|---|
| Mon | Ghearing | Ghearing |
| Tue | Blank / Fields | Ghearing / Fields |
| Wed | Yoo / Marcuse | Marcuse |
| Thu | Ghearing | Ghearing / Fields |
| Fri | Yoo / Fields | Yoo / Marcuse |
Fellows: Pediatric Rotation
Focus: Neonatal/early childhood EEG, syndromes, genetics, keto, pre-surgical. (Kravis 5th Floor).
| Time | Activity |
|---|---|
| AM (Mon-Fri) | 8-11 AM: Read inpatient EEGs (Kravis, NICU, MSW), elective EMUs. |
| Tue/Thu AM | 9 AM: Peds Neuro Clinic. Finish non-EMU reading before 9. |
| PM (1-5) | Peds Ambulatory Reading. Clinics: Tue PM (Dr. La Vega at MSBI), Fri PM (Dr. La Vega at MSH). |
Info for ICU Fellows
- 1st Year Rotation (1 mo): Read 1 NSICU LTM in AM. Read 1-2 routines in PM. Attend conferences.
- Sub-EEG Track (2-3 mo): Read ALL NSICU studies. Same responsibilities as Epilepsy fellows but focused on ICU.
Other Responsibilities
MDC Preparation
Prepare epilepsy surgery cases (~1 new, 1 follow-up). Wed 4-5:30 PM. Review with attending prior. Use
.mdc smartphrase.
EEG Conferences
Bi-weekly (Mon 12:30): Present 2-3 interesting cases. Include pediatric cases.
EEG Reporting Protocol
Daily Must-Do's
- Include brief clinical history.
- List daily CNS-medications with doses.
- Annotations: Mark at least 3 (Awake, Asleep, Interictal).
- Use "Custom" field to mark findings for database/teaching.
Template Types (EPIC Smart Phrases)
| Smartphrase | Use |
|---|---|
2026VEEG |
Standard VEEG (w/ prior routine in 6mo) |
2026VEEGNEONATAL |
Neonate VEEG |
2026EMUVEEG |
ALL EMU admissions (Kravis, MSH, MSW) |
2026BASELINE VEEG |
New hookup without prior routine. |
2026SAHBASELINE... |
Subarachnoid Hemorrhage (Alpha/Delta ratio) |
2026INTRACRANIAL... |
Intracranial studies (Know electrode locations!) |
2026AMBULATORY |
Prolonged outpatient studies |
Call Schedule & Sign-outs
Weekdays (5PM-8AM): Epilepsy for all MSHS hospitals.
Weekends (Fri 5PM - Mon 8AM): MSH & MSW Inpatients. (Rounding physically at MSW).
Sign-Out Template
Hi! This is MSW Friday signout. There are ### EMU patients and ### LTMs. EMU: [Last, First] ([Attending]), [Date]. Home meds: ... 65M with focal epilepsy. No seizures yet. Plan: Wean meds. LTM: [Last, First]. ASMs: ... 92M cardiac arrest. EEG: Burst suppression. Weekend Notes: Consult patient, monitor for 24h seizure freedom.
Transfer & Consult Guidelines
Appropriate Transfers to EMU
- Medically stable patients with frequent breakthrough seizures.
- Needs urgent med adjustment with monitoring.
- Characterization of PNES (medically stable).
- EXCLUDE: Acute stroke/sepsis, active suicidal/homicidal ideation, intubated (unless stable SE for weaning).
Appropriate E-Consults
- Super-refractory SE (med management depends on EEG).
- Simple management (PO to IV conversion) unaddressed by Gen Neuro.
- Note: Always communicate directly before placing e-consult.
Driving Laws
| State | Reporting | Seizure-Free Period | Notes |
|---|---|---|---|
| New York | No | 1 Year* | *Less at DMV discretion. MD statement required. |
| New Jersey | Yes | 6 Months | Physicians MUST report. |
| Connecticut | No | DMV Discretion | No set period. |
NY Commercial: Generally disqualified if diagnosed with seizure disorder.
Lecture Curriculum (2026-2027)
- Jul: Report writing, Montages/Polarity, Normal/Abnormal EEG, Quant EEG.
- Aug: Status Epilepticus, Semiology, IIC, Surgery/Intracranial.
- Sep: ASMs, VNS, Neonatal/Infancy Part 1.
- Oct: NSICU expectations, Ped EEG, RNS, AI Detection, DEE.
- Nov: Critical Care Terms, Women's Issues, Genetics.
- Dec: First seizure, Med prophylaxis.
- Jan: IIC Mgmt, Neurorads, SUDEP.
- Feb: SAH, PNES, Autoimmune.
- Mar: NORSE, Neuropsych, Disparities.
- Apr: Sleep/Movement, Functional, QOL/Driving.
- May: Neonatal SE, MEG/Source Loc.
- Jun: HIE/Prognostication.