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Tanya Lehky, MD
Sara Inati, MD
Entry Id: TP-39

Eligibility Criteria
Qualified candidates must complete an ACGME-accredited neurology residency training program or the equivalent before entering this program. They must also have a valid, unrestricted US medical license.

Overview
The training program for clinical neurophysiology is ACGME-accredited program and affiliated with the Neurology residency program of the National Capital Consortium in Bethesda, MD. The candidates who complete this training program are eligible for examinations given by the American Board of Psychiatry and Neurology for certification in Clinical Neurophysiology, the American Board of Clinical Neurophysiology, and the American Board of Electrodiagnostic Medicine. There are two fellowship pathways, Electroencephalography (EEG) and Electromyography (EMG). Prospective applicants should apply specifically to either the EEG or EMG position.

The Clinical Neurophysiology program is designed to expose the clinical fellows to a diverse number of neurophysiological techniques. Depending on the pathway, the fellow will either concentrate on electroencephalography related techniques or electromyography related techniques, but all fellows are required to become facile in both subspecialities. The fellows are responsible for interpreting the daily EEG and EMG studies performed at the NIH Clinical Center. They are exposed to a mix of patients, ranging from the unique research population at the NIH Clinical Center to the community based patients at Walter Reed National Military Medical Center and Children’s National Medical Center. Didactic training includes weekly Clinical Neurophysiology Conference in which both EEG and EMG fellows prepare regular presentations alternating with faculty and invited lectures on special neurophysiological techniques. There are daily EEG reading sessions and weekly EMG case reviews in which interesting cases are discussed in detail. The fellows also attend the weekly NINDS grand rounds and neuroscience conferences with the opportunity to attend a number of conferences in the larger NIH community.

Electroencephalography
Sara Inati, M.D.
This one year fellowship in Clinical Neurophysiology /EEG is offered in combination with an additional year of training in clinical epilepsy with the Clinical Epilepsy Section at NIH. The fellow is responsible for the daily interpretation of EEG recordings, long term video EEG monitoring and evoked potential recordings, as well as magnetoencephalograms (MEG), intracarotid amobarbital procedures, and intracranial EEG recordings. The fellow will also gain a basic foundation in EMG and sleep recordings. The fellow is responsible for presentations at the multidisciplinary epilepsy surgery conference, in addition to the Clinical Neurophysiology Conference, and for teaching rotating neurology residents. Fellows are expected to become involved in a research project, usually involving neuroimaging or a treatment trial, with the goal of developing a basic foundation for pursuing independent research in the field of epilepsy.

Electromyography
Tanya Lehky, M.D.,
The EMG fellowship position focuses on performing and interpreting electrodiagnostic tests in neuromuscular disorders, neuropathies, and autonomic disorders. Training encompasses a wide variety of techniques including transcranial magnetic stimulation, single-fiber EMG, quantitative motor unit analysis, and autonomic nervous system testing. There are opportunities to participate in a number of clinical trials using a wide spectrum of outcome measures and regularly engage in the electro diagnoses of complex patients. The fellow also participates in the monthly botulinum clinic for movement disorders. The fellowship includes neuromuscular and EMG clinics at Walter Reed National Military Medical Center and Children’s National Medical Center. The training period is one year and fellows who complete the program will be eligible to sit for the Clinical Neurophysiology Boards (APBN) and the EMG boards (ABEM).

• Mary Kay Floeter, MD, PhD Investigations of spinal circuits and motoneurons in neurological disorders, Diffusion tensor imaging in motor neuron disorders.
• Sara Inati, MD Pathophysiology and surgical treatment of epilepsy, presurgical evaluation and long-term epilepsy monitoring of epilepsy patients, magnetoencephalography
• Tanya Lehky, MD Neurophysiology and Clinical trial outcome measures
• Susumu Sato, M.D. Pathophysiology and surgical treatment of epilepsy, long-term epilepsy monitoring, magnetoencephalography

Selected Papers Authored by Program Faculty

• Kwan JY, Jeong SY, Van Gelderen P, Deng HX, Quezado MM, Danielian LE, Butman JA, Chen L, Bayat E, Russell J, Siddique T, Duyn JH, Rouault TA, Floeter MK. Iron accumulation in deep cortical layers accounts for MRI signal abnormalities in ALS: correlating 7 Tesla MRI and pathology. PLoS One. 2012;7(4):e35241
• Rakocevic G, Floeter MK. Autoimmune stiff person syndrome and related myelopathies: understanding of electrophysiological and immunological processes. Muscle Nerve. 2012 May;45(5):623-34
• Iwata NK, Kwan JY, Danielian LE, Butman JA, Tovar-Moll F, Bayat E, Floeter MK. White matter alterations differ in primary lateral sclerosis and amyotrophic lateral sclerosis. Brain. 2011 Sep;134(Pt 9):2642-55
• Raphaelson M, Inati SK. Treating sleep disorders in neurology practice. Neurol Clin. 2012 Nov;30(4):1007-25
• Wang XM, Lehky TJ, Brell JM, Dorsey SG. Discovering cytokines as targets for chemotherapy-induced painful peripheral neuropathy. Cytokine. 2012 Jul;59(1):3-9.
• Lehky TJ, Iwamoto FM, Kreisl TN, Floeter MK, Fine HA. Neuromuscular junction toxicity with tandutinib induces a myasthenic-like syndrome. Neurology. 2011 Jan 18;76(3):236-41.
• Fernández-Rhodes LE, Kokkinis AD, White MJ, Watts CA, Auh S, Jeffries NO, Shrader JA, Lehky TJ, Li L, Ryder JE, Levy EW, Solomon BI, Harris-Love MO, La Pean A, Schindler AB, Chen C, Di Prospero NA, Fischbeck KH. Efficacy and safety of dutasteride in patients with spinal and bulbar muscular atrophy: a randomised placebo-controlled trial. Lancet Neurol. 2011 Feb;10(2):140-7
• Theodore WH, Martinez AR, Khan OI, Liew CJ, Auh S, Dustin IM, Heiss J, Sato S. PET of serotonin 1A receptors and cerebral glucose metabolism for temporal lobectomy. J Nucl Med. 2012 Sep;53(9):1375-82
• Duke ES, Tesfaye M, Berl MM, Walker JE, Ritzl EK, Fasano RE, Conry JA, Pearl PL, Sato S, Theodore WH, Gaillard WD. The effect of seizure focus on regional language processing areas. Epilepsia. 2012 Jun;53(6):1044-50.
• Appel S, Duke ES, Martinez AR, Khan OI, Dustin IM, Reeves-Tyer P, Berl MB, Sato S, Gaillard WD, Theodore WH. Cerebral blood flow and fMRI BOLD auditory language activation in temporal lobe epilepsy. Epilepsia. 2012 Apr;53(4):631-8

Program Graduates
The following are recent graduates and their current positions on completing the Clinical Neurophysiology fellowship:

Completed Program 2010

• Omar Khan, M.D., Private practice, Epilepsy surgery program

Completed Program 2009:

• Sabrina Miranda, D.O., Private Practice.
• John Hughes, M.D., Assistant Professor, USUHS.

Completed Program 2008:

• Liviu Craciun, M.D., PhD, Private Practice.
• Rebecca Fasano, M.D., Assistant Professor, USUHS.

Completed Program 2007:

• Sadat Shamim, M.D., Private practice. Epilepsy and Clinical Neurophysiology.

Completed Program 2006:

• Zoltan Mari, M.D., Assistant Professor, Johns Hopkins University.
• Clarissa Liew, M.D., Private practice. Epilepsy and sleep.

Completed Program 2005:

• Vitalie Lupu, M.D., Private practice. EMG and neuromuscular disorders.
• Robert Bonwetsch, M.D., Private practice. Epilepsy and sleep.

Clinical Neurophysiology-Fellowship: Prospective candidates should apply specifically to the EMG or EEG position. Each position is a one year position in an ACGME-accredited training program. The EEG position is combined with a one year epilepsy training position. The EEG and epilepsy programs interview prospective candidates concurrently.

Application requirements include curriculum vitae, letter of professional interests, letters of recommendation, and a valid unrestricted US license.

For further information, applicants should contact the individuals specified below:

General information and EMG position Tanya J. Lehky, MD Program Director, Clinical Neurophysiology Program EMG Section National Institute of Neurological Disorders and Stroke National Institutes of Health Building 10 CRC, Room 7-5680 10 Center Drive MSC 1404 Bethesda, MD 20892 Phone: (301) 496-7428 Fax: (301) 402-8796

EEG Position Sara K. Inati, M.D. Associate Program Director, Clinical Neurophysiology Program EEG Section National Institute of Neurological Disorders and Stroke National Institutes of Health Building 10 CRC, Room 7-5680 10 Center Drive, MSC 1404 Bethesda, MD 20892 Phone: (301) 496-5121 Fax: (301) 402-8796

Electronic Application
The quickest and easiest way to find out more about this training program or to apply for consideration is to do it electronically.

The NIH is dedicated to building a diverse community in its training and employment programs.

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