A health care professional with a child patient
By Aaron Lynn Cardon, MD

Pursuing a Career in Pediatric Epilepsy? Learn at the Forefront of the Field

Advanced technology is improving pediatric epilepsy treatment everywhere, but the key to more precise diagnoses and effective treatment is the internal drive within UNM HSC physicians and trainees to more deeply understand the intricacies of each patient’s unique condition.

With fast-paced breakthrough research in both pediatric epilepsy and neurology in general, there’s never been a more exciting time to study and practice pediatric neurology. New diagnostic and treatment approaches are giving more families of children with seizure disorders better access, more options, and a higher quality of life than ever before.

As a child neurology resident at UNM Health Sciences Center, you will be at the epicenter of impactful epilepsy care that reaches the kids and families who need specialized neurology care most.  

UNM HSC brings together expertise and technology as we continue to build our pediatric epilepsy program. As the only fellowship-trained pediatric epilepsy specialist in the state, I’m thrilled to increase the capabilities for the 2 million residents of New Mexico we serve through the UNM Comprehensive Epilepsy Center—the only Level 4 epilepsy center in New Mexico accredited by the National Associations of Epilepsy Centers. 

Approximately 5,000 to 10,000 children in the state are estimated to have epilepsy, and I aim to establish our Comprehensive Epilepsy Center as the home for epilepsy management for each of them

Patients are referred to us through many avenues, from concerned parents to the ER. Every pediatric neurologist at UNM HSC is experienced in treating epilepsy. For complex cases—such as drug-resistant epilepsy—I partner with faculty and trainees to dig deeper into a patient’s overall health and find a solution.

Together with our residents, we work with the most advanced technology and research, becoming proficient in three unique areas that can transform the course of a child’s epilepsy care:

  1. 1. Overcoming biases to educate and connect with patients and providers

  2. 2. Mastering electroencephalography (EEG) technology

  3. 3. Using clinical syndromes to provide more accurate diagnoses

1. Overcoming Bias with Open Conversations About Epilepsy

To build trust-based relationships with patients and their families, it’s important to not make any assumptions about their biases, background, or level of understanding. The same goes for communicating with the family’s other health care providers who may not understand the long-term implications of uncontrolled epilepsy.

Having open conversations is a good way to start, and our residents often help remind me of this. Families and their providers come to us needing answers, but half of all epilepsies have no known cause. Communicating limited answers to even the most informed individuals can be challenging. We train residents to both learn and lead, and to expect difficult conversations 50% of the time.

Research suggests that many providers view neurology as the most challenging specialty, which can intimidate some physicians whose patients may have neurological symptoms. As a pediatric epileptologist, part of my role—and what I teach our residents—is to help other health care providers feel more comfortable identifying epilepsy symptoms and collaborating with specialists to make sure our patients get the best care.

2. Mastering EEG, the Cornerstone of Epilepsy Care

As a trainee, you’ll have a lot of exposure to EEG imaging tests, which detect brain wave patterns to help us see where a seizure originated and plan for possible surgical treatment. To become a successful child epilepsy neurologist, you’ll need to build a foundational understanding of how this technology works.

EEG is the cornerstone of epilepsy diagnosis and treatment because of how it distinguishes abnormal electrical activity. If a patient is taking medication but their EEG shows continuously abnormal patterns, we need to provide different treatment, such as electrical stimulation devices, dietary changes, or surgery.

Though surgery is proven to be both safe and effective for at least half of patients with drug-resistant epilepsy, less than 1% of them receive it. For children with drug-resistant epilepsy, studies have shown that surgery improved quality of life and was more likely to end seizures after one year. With this type of data in mind, our goal is to increase our own research, as well as the number of surgical evaluations we perform in partnership with our neurosurgeons.

Get a glimpse at the latest discoveries in our 50,000 square feet of lab space

As a resident or fellow, you can help us perform leading research that will improve the health and well-being of patients

3. Improving Accuracy with Clinical Syndromes

Across the board, we see dramatic improvements in patients’ experiences with epilepsy as our diagnoses get more precise. And we do that by focusing on the intricacies of a patient’s pathology. The pattern that develops after reviewing test results and clinical syndromes helps us tailor treatment to a patient’s distinct condition.

A shared trait among successful epileptologists and trainees is the desire and aptitude to define a disease by its clinical syndrome—specific groupings of symptoms ranging from age to intellectual development to comorbidities. The challenge is that hundreds of clinical syndromes exist, which is a hurdle in understanding drug-resistant epilepsy.

Making this challenge more complicated—and more exciting—are advances in genetics, which is becoming increasingly important as we deepen our understanding of epilepsy. Genetic epilepsies are estimated to include over 30% of all epilepsy syndromes.

Learning the broad categories of syndromes provides a starting point as you narrow your pathway to a more final diagnosis. We encourage trainees to think outside of the box to understand a patient’s complete clinical story and provide the right syndrome diagnosis when possible.

Picture a Day in Pediatric Neurology

Our Child Neurology residents spend two years in pediatric neurology leading inpatient care, serving in outpatient clinics, and taking elective rotations. A typical day during an epilepsy rotation would include:

  • Conducting pre-rounds in the morning to check on patients who are admitted for long-term EEG studies. You will be fully responsible for their care, and UNM HSC neurology faculty will support you every step of the way.
  • Leading the on-site neurology team on rounds to visit these patients and provide updates on their condition.
  • Reviewing EEG results and other data to look for seizure patterns and understand how your patients are responding to current treatment.
  • Discussing these results with the epilepsy attending physician to determine how to treat your patients’ epilepsy.
  • Attending didactics, where you’ll learn about new and upcoming research on techniques and technology for diagnosing and treating epilepsy.

We can customize your elective rotations to focus on your specific interests, so be sure to share your preferences with our program director. Learning the core causes of and treatments for epilepsy will set you up for success as you expand your study and practice.

From neurostimulation therapy to minimally invasive surgery, science and practice are aligning in a way that allows us to provide innovative, life-changing epilepsy treatments. I don’t know what could be more rewarding than that for a doctor!

Looking for an impactful education in neurology?

Schedule a call with JJ Maloney, Medical Education Program Manager for the UNM HSC Department of Neurology
Categories: Neurology