Neurology Residency Training Facilities
In-patient neurology residency training is carried out at two sites, University Hospitals Cleveland Medical Center and Louis Stokes Cleveland VA Medical Center. The different patient mix at the two hospitals provides residents with thorough exposure to the broadest possible range of neurologic illness.
University Hospitals Cleveland Medical Center
The Neurology service at UH Cleveland Medical Center cares for inpatients in the Lerner Tower 4. There is a 14-bed intensive care unit, staffed by neurologists trained in intensive care and shared with the Department of Neurological Surgery. The Department has a full range of neurodiagnostic laboratories (including EEG, video-EEG monitoring unit, EMG, neurovascular ultrasound, autonomic function, neuro-ophthalmology, and sleep centers).
Louis Stokes Cleveland VA Medical Center
Within walking distance of UH Cleveland Medical Center, is the Louis Stokes Cleveland Veterans Affairs Medical Center. Neurology Service at the VA is active in clinical care and academic research. It is closely affiliated with two VA Research Centers of Excellence, the FES (functional electrical stimulation) and APT (advanced platform technology) Centers. The FES Center focuses on the application of electrical stimulation to enhance the functional capacities of individual with motor deficits due to stroke, multiple sclerosis and spinal cord injury.
There is also a Gait laboratory at the VA, that performs research that is aimed at enhancing motor recovery after stroke by incorporating multiple techniques including FES, robotics, advanced treadmill training techniques and motor learning strategy to maximize recovery of upper and lower extremity motor functions and abilities to function independently.
The APT center is developing new biomaterials and electronics to enhance the range of applications of biomedical engineering to neurological diseases. Another outstanding clinical and research resource is the Daroff/Dell'Osso Ocular Motility Laboratory, which includes world class researchers: Drs. John Stahl and Mark Walker. Drs. Robert B. Daroff and Lou Dell'Osso founded the initial eye movement laboratory in the VA almost 30 years ago. The ocular motility laboratory studies control of eye movements and how eye movements are disturbed in neurological diseases.
The Neurology service cares for acutely ill patients on its own wards in this 683 bed hospital, and provides outpatient care for veterans throughout Northern Ohio. Dr. Ronald Riechers is the Chief of the VAMC neurology service. He joins a distinguished faculty who provide care and also participate in active clinical and basic research programs. The medical center has been recognized for more programs of clinical excellence than any other VAMC: Open Heart Surgery, Care of the Seriously Mentally Ill, Geriatric Evaluation and Management, Substance Abuse Care, Spinal Cord Injury Care, Medical Care of the Homeless, and Domiciliary Care of the Homeless.
Additional Training Facilities
- Training Outpatient Facilities
Residents see outpatients primarily at UH Cleveland Medical Center and Louis Stokes Cleveland VA Medical Center. At UH Cleveland Medical Center, the neurology outpatient is based on the fifth floor of the UH Bolwell Health Center, part of the UH Neurological Institute.
In addition, the neurology staff see patients in surrounding community outpatient centers. Residents may join the faculty at some of the following locations during their second year EMG continuity experience or during outpatient electives.
- Clinical Laboratories
Four diagnostic laboratories are essential to many aspects of neurological care.
The Autonomic Laboratory evaluates patients with disorders affecting the autonomic nervous system. These disorders include multiple system atrophy, pure autonomic failure, reflex sympathetic dystrophy, hypotension, postural orthostatic tachycardia syndrome (POTS), fainting, abnormalities of sweating, bladder and sexual dysfunction. The laboratory is located in the fifth floor of the Bolwell Health Center at UH Cleveland Medical Center. Satellite laboratories are located at UH Westlake Health Center and UH Minoff Health Center. All testing is non-invasive and includes tilt table, quantitative sudomotor reflex testing (QSART), whole body sweat testing and laser Doppler flowmetry.
EEG (Electroencephalography) is performed for outpatients in the EEG suite located on the second floor of the Bolwell Health Center building at UH Cleveland Medical Center. Over 3000 studies are done annually on outpatients. In addition, the laboratory also conducts a large number of portable studies on patients hospitalized on the wards and intensive care units.
Video-EEG Monitoring Unit
Both adult and pediatric studies are performed in their respective Video-EEG Monitoring Units. These are inpatient units where patients undergo continuous monitoring. This unit is most helpful in determining if a patient's intermittent symptoms are due to seizures. Monitoring is also frequently used to assess the efficacy of anticonvulsant medicines and in the pre-surgical evaluation of patients before possible epilepsy surgery. The pediatric Video-EEG Monitoring Unit is located on the seventh floor of UH Rainbow Babies and Children's, and the adult unit is located on the fourth floor of the Lakeside building.
Nerve conduction studies and electromyography (EMG) are available for the diagnosis of most peripheral nerve and muscle disorders. The EMG laboratory evaluates over 2000 patients per year at five locations, including the 5th floor of the Bolwell Health Center at UH Cleveland Medical Center, University Suburban Health Center, UH Minoff Health Center, and UH Westlake Health Center. Services available include nerve conduction studies, needle electromyography, single-fiber EMG, ischemic forearm blood testing and EMG guided Botox. The EMG laboratory is extremely user friendly and offers multiple site scheduling, low wait times and quick reporting (usually same day). Important information for patients about electromyography testing is available on the UH Neurological Institute website.
Daroff-Dell'Osso Ocular Motility Laboratory (OMLAB)
Located at Louis Stokes Cleveland VA Medical Center, OMLAB was started by a collaborative effort between Robert B. Daroff and Louis F. Dell'Osso to study the measurement of human eye movements as it relates to neurological, visual and vestibular disorders and occular motor system function/dysfunction. OMLAB serves as a prototype for subsequent interdisciplinary groups who study ocular motility and it has achieved international recognition as the source of cutting-edge ocular motor research. Investigators from OMLAB engage in collaborative research with investigators from other laboratories throughout the world.