Clinical Fellowship In Parkison's Disease & Movement Disorders

• A fellow in Parkinson’s Disease and Movement Disorder will attend outpatient clinic (Movement Disorder clinic and General Neurology clinic) and do primary work up and follow up of patients with a variety of hypo and hyperkinetic Movement Disorders. He/ she will see both adult and paediatric patients with Movement Disorders and he/she will be supervised by one of the Movement Disorder Specialist. He/ she will learn the scales used to evaluate a variety of Movement Disorders. In the Movement Disorder clinic, he/she will focus on detail evaluation with different scales and questionnaires. He/she will be expected to do detailed work up of at least 10 new patients and 10 follow up patients in a week. The fellow will manage the patients with Movement Disorders admitted in the ward see and present to his supervisor.
•  He/she will be seeing and managing Movement Disorder Emergencies in the Casualty and Ward, under supervision.
• He/she will learn video recording of the patients and later edit and present the recordings in the Video sessions.
•  He/she will also be involved in regular entry of clinical data in the existing Movement disorder database, which will be integrated with Videos of patients, electrophysiology, Botulinum Toxin injections and functional Neurosurgery wherever available.
• The candidate will be part of the Department of Neurology and can participate in the on-call roster for general neurology.

• In the first 2 months, the Fellow will be trained on how to give injections of Botulinum Toxin in different types of movement disorders and spasticity. He will assist his supervisor in the Botulinum Toxin Injection sessions, which is currently once a week (3 hours). He/she will also be trained in giving EMG and USG guided injection. In the next 4 months he/she will be allowed to inject under supervision. In the last 6 months he will be allowed to inject independently.

• In the first 3 months, the Fellow will be taught, in the electrophysiology session (twice a week, approximately 4 hours) how to do, analyze and interpret: i. Multichannel surface recording and use of accelerometer in evaluation of different types of tremor
• Evaluation of dystonia using recording of surface EMG (multichannel)
• Evaluation of myoclonus/ jerks using surface EMG, accelerometer, long loop latencies, somatosensory evoked potentials, pre-movement potentials, jerk locked EEG, etc.
• In the last 9 months of Fellowship, he/she should be able to carry out the above procedures independently and write reports.

The Fellow will actively participate in the Functional Neurosurgery program in treating patients with Parkinson’s disease, tremor and dystonia. He will learn selection of patients for surgery and pre- and post-operative assessments of patients with scales and videos. He will attend the Operation Theatre during the operations, and will also learn how to do target selection and later programming in case of DBS

Fellow will also be interacting with the following departments regularly:

•  Neuroimaging
• ii) Nuclear-medicine
• iii) Genetics
•  Neuro-rehabilitation

•  Journal Club (once a month)
• Video Sessions (once a week)
•  Bedside case discussions (twice a month)
• Neuroimaging of selected Movement disorders (twice a month) in collaboration with Department of Neuroimaging
•  Involvement in ongoing thesis/research in Movement Disorders (vi) Participate in the academic activities of the Neurology Department
• Write up a new proposal for research
•  Chart reviews, and presenting scientific paper
•  Expected to write at least one original and one Review article during his/her one-year tenure