Clinical Neurophysiology Training in a Developing Country: Institutional Resources and Profiles.

PURPOSE: The purpose of this study was to describe the characteristics and preferences of clinical neurophysiology (CN) fellows, as well as the resources available for their training, in a developing country such as Mexico. METHODS: An online survey (25 questions) was given to Mexican CN fellows from May to June 2017, covering their reasons for choosing the CN subspecialty, their activities, future plans, institutional resources, and administrative staff. Descriptive statistics were used. RESULTS: Total respondents: 20/22 (90%), 65% female from 7 CN centers (80% public and 20% private hospitals) in Mexico City. Seventy-five percent chose CN out of personal interest, and all were not unsatisfied with their academic program. Most plan to work in private practice (75%) and are interested in learning EEG (85%) and intraoperative monitoring (75%-85%). The highest-reported training time by CN area allocated by the programs was as follows: EEG (27%), electromyography (22%), and evoked potentials (16%). The average number of fellows per center was 4; 75% of the centers perform epilepsy surgery, of which 60% offer invasive intracranial studies for the evaluation of surgical candidates. CONCLUSIONS: Mexican CN fellows are satisfied with their choice and with the academic program. They are increasingly interested in intraoperative monitoring, which is not addressed in current Mexican CN Programs.

Transcranial Alternating Current Stimulation: A Potential Risk for Genetic Generalized Epilepsy Patients (Study Case).

Transcranial alternating current stimulation (tACS) is a re-emergent neuromodulation technique that consists in the external application of oscillating electrical currents that induces changes in cortical excitability. We present the case of a 16-year-old female with pharmaco-resistant juvenile myoclonic epilepsy to 3 antiepileptic's drugs characterized by 4 myoclonic and 20 absence seizures monthly. She received tACS at 1 mA at 3 Hz pulse train during 60 min over Fp1-Fp2 (10-20 EEG international system position) during 4 consecutive days using an Endeavor™ IOM Systems device® (Natus Medical Incorporated, Middleton, WI, USA). At the 1-month follow-up, she reported a 75% increase in seizures frequency (only myoclonic and tonic-clonic events) and developed a 24-h myoclonic status epilepticus that resolved with oral clonazepam and intravenous valproate. At the 2-month follow-up, the patient reported a 15-day seizure-free period.