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The department has specialized divisions, including ambulatory neurology, neurophysiology, neuro-ophthalmology, neuromuscular diseases, pediatric neurology, and molecular neurobiology. Research and specialized programs include the Epilepsy Monitoring Unit, the Neurophysiology Laboratories, the Ocular Motility Research Program, the Molecular Neuroscience Research Facility, the Neuromuscular Disease Center, the Parkinson's Disease Research Center (at McGuire VA Hospital), and the Headache Clinic.
Division of Adult Neurology
The Division of Adult Neurology sees approximately 10,000 outpatients annually. Subspecialty clinics are active in a variety of disciplines including neuromuscular disorders, headache, neuro-ophthalmology, epilepsy, and dementia. A variety of clinical trials are carried out in the outpatient setting, including studies on new therapies for Parkinson's Disease, Multiple Sclerosis, epilepsy, cerebrovascular disease, and headaches.
Division of Child Neurology
The Child Neurology Division has grown to be one of the largest academic child neurology divisions in the country and includes six full-time faculty. All members have cross appointments in both the Department of Pediatrics and Physical Medicine and Rehabilitation. Patients are seen in the Children's Medical Center of the VCU Health System, the regional level 4 neonatal nursery, as well as Children's Hospital of Richmond. Subspecialty clinics include epilepsy, muscular dystrophy, birth defects and general child neurology patients. These are dispersed throughout the week so that there is at least one child neurology clinic daily. Research interests include epilepsy and anti-epileptic drug development, neuromuscular disorders, sleep disorders, auditory neurophysiology and evoked potentials, and EEG, EMG. Fellows in Child Neurology are accepted for the three-year training program.
Division of Clinical Neurophysiology
The Neurophysiology Laboratories represent one of the largest laboratories in clinical neurology, performing approximately 3,000 EEGs, over 800 evoked potentials and 1,000 EMGs per year. The lab also performs brain mapping and 24-hour ambulatory EEG monitoring. In addition to the ongoing clinical activities, there are multiple research projects undertaken by the faculty including major studies on morbidity and mortality in status epilepticus and head trauma. These are large ICU based clinical studies using advanced techniques in both EEG and evoked potentials. Additionally, there are numerous other smaller studies undertaken by the laboratory physicians in EEG, EPs, and EMG.
Division of Neuro-Ophthalmology
The Division of Neuro-ophthalmology provides clinical experience for residents in neurology, neurosurgery and ophthalmology, in a primarily ambulatory setting, seeing over 600 new patients and 1,200 established patients annually. A limited inpatient and an active consultation service complement the outpatient setting. Additional services include Humphrey Static Perimetry, a highly sophisticated eye movement laboratory providing comprehensive ocular motor recordings including ENG, and comprehensive visual neurophysiology including pattern and flash ERG, pattern and flash VEP and PEOG studies. Clinical research is ongoing in visual neurophysiology, selected disorders of ocular motility, particularly those associated with head trauma, and in cerebrovascular disease.
Epilepsy Monitoring Unit
The Epilepsy Monitoring Unit provides intensive seizure monitoring on the 11th floor of VCH Medical Center Main Hospital. Four beds are available with continuous video and EEG recording under the supervision of physicians, technicians and nursing personnel. The unit is designed to function both as a diagnostic service and as a center for presurgical evaluation. Patients referred for surgical therapy are evaluated by neuropsychological tests, MRI studies, PET and SPECT studies, speech and language evaluation, as well as EEG and clinical evaluations. The results are then discussed in a multi-disciplinary conference in order to assess as accurately as possible the risk/benefit ratio for a surgical approach.
Molecular Neuroscience Research Facility
The Department of Neurology maintains and staffs a diversified neuroscience research program. The multi-disciplinary Molecular Neuro-science Research Facility conducts experiments in molecular genetics, neuro-pharmacology, physiology and clinical neurophysiology. The Department has several NIH research awards, as well as an Epilepsy Center and core research activities. Numerous clinical studies as well as basic science research opportunities are available.
Residents can elect to rotate through the laboratory. Opportunities are available for publications and training in basic research techniques, both at a clinical and molecular level. Fellowship support for research is also available, if desired. Support is available for presentation of research at national meetings.
Neuroradiology
The Department of Radiology's Neuroradiology Division is currently running three MRI units and a 3T magnet. A dedicated Neuroangiography Suite and a shared Angiography Suite are also present. An additional Neuroangiography Suite with 3D capability with a PET scanner has been recently installed. There are five CT scanners, one with multi-slice capabilities, and upgrades planned on the remaining.
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