Over the past few years, the UNC Department of Neurology has developed two specialized follow-up clinics for Neuroscience Intensive Care Unit patients recovering from severe acute brain injuries: the Post Acute Symptomatic Seizure (PASS) and Neurorecovery clinics.
PASS Clinic
The PASS clinic, overseen by Dr. Clio Rubinos, who has dual training in clinical neurophysiology-epilepsy and neurocritical care, offers a specialized continuation of care for patients who have experienced acute symptomatic seizures either en route to or during their time in the Neuro ICU. Acute symptomatic seizures are those seizures, clinical or electrographic, that occur in close temporal correlation with brain injury, whether structural (such as traumatic brain injury, stroke, or tumor) or non-structural (like meningitis, hyponatremia, hyperglycemia, or toxin-related causes), posing a risk for developing epilepsy. The clinic’s goal is to provide tailored assessments regarding the necessity of continuing anti-seizure medication, adjusting dosage, or changing medications altogether. PASS clinic visits address questions that patients or their families may have about their hospital course and outcomes. It also offers therapies and referrals for complications arising from acute critical illness, both physically and emotionally.
Post Acute Symptomatic Seizure Investigation and Outcome Network (PASSION)
Dr. Rubinos and other collaborators from 5 PASS clinics at other U.S. sites have established the Post Acute Symptomatic Seizure Investigation and Outcome Network (PASSION). PASSION has developed a prospective patient registry to assess long-term epilepsy risk, functional and cognitive outcomes, biomarkers of interest, and efficacy and adverse effects of anti-seizure medications amongst patients with acute symptomatic seizures. Other PASS clinic sites include the Cleveland Clinic, the Yale School of Medicine, Brown University, and Massachusetts General Hospital.
The Neurorecovery Clinic
The Neurorecovery clinic, led by Dr. Julia Carlson, focuses on functional recovery after acute neurological injuries, screening for post-ICU syndrome (PICS) related complications, provision of personalized prognosis, and incorporation of palliative care as needed. The clinic’s goal is to ensure that brain injury survivors have their needs met, including adequate rehabilitation services by collaborating with physical medicine and rehabilitation providers at UNC, proper follow-up with other post-hospital providers, and additional consultations and referrals as needed. Dr. Carlson collaborates with other physicians interested in neurorecovery at Massachusetts General Hospital, University of Maryland, and University of Connecticut/Hartford Hospital among others in the Neurorecovery Consortium. Dr. Carlson recently recorded a Neurocritical Care Society podcast on post-ICU clinics that is available at the following link: https://www.neurocriticalcare.org/Events/Event-Calendar/Podcasts.
For Patient referral, please contact:
UNC Hospitals Neurology Clinic
Fax: 984-974-2285
Phone: 984-974-4401 (Option 2)
Email: neurologyreferrals@unchealth.unc.edu