Department of Neurology

The department of neurology provides advanced diagnostic and treatment services for disorders affecting the brain, spinal cord, and peripheral nervous system.

About

Program Overview

At Carilion Neurology, we offer advanced and comprehensive treatments for with conditions affecting the brain, spinal cord and peripheral nervous system. Through advanced diagnostics and evaluations, our team of experienced neurologists will guide patients through treatment options for ailments and disabilities such as stroke, epilepsy, multiple sclerosis and other movement disorders. Our expert team works together with other specialties to give every patient the best outcome and overall quality of life possible.

Virginia Tech Carilion Partnership

Lev 4 Epilepsy
Region’s only Level 4 Comprehensive Epilepsy Center, offering Comprehensive Epilepsy Center, Level 4 more complex forms of intensive diagnostics, monitoring and treatment.
JC
Designated Advanced Thrombectomy Capable Certification, providing the critical elements to achieve long-term success in improving outcomes for stroke patients.

Mission, Goals and Strengths

Mission: To ensure the best quality of life possible for all of our patients.
Goals: Create a multi-specialty section of Neurology while increasing research and scholarly work output.
Strengths: Excellent core group of faculty with many subspecialties. 

Message from Leadership

Welcome to Neurology at Carilion Clinic. We are dedicated to provide excellent neurological care to our patients while engaging in training future neurologists and conducting research to understand and ultimately improve treatments and outcomes of neurological disorders.

Patient care is our first priority and we strive to provide care to each patient with kindness while bringing advance technologies and treatments to individual level. We are building highly specialized programs in various neurological subspecialties and are proud to be certified as a Primary Stroke Center with Gold Seal of Approval and a Level 4 Comprehensive Epilepsy Program. We are also the location for the region’s only Muscular Dystrophy Association Clinic.

Our physicians are also faculty at the Virginia Tech Carilion School of Medicine. We train and mentor residents and medical students as well as allied health professional students. We are one of the only 3 Neurology residency programs in the Commonwealth of Virginia. While all of our neurologists are educators, majority are also engaged in research. We conduct clinical research at Carilion Clinic while we partner with researchers at Fralin Biomedical Research Institute at VTC and Virginia Tech for research in basic and translational neurosciences.

Our focus is to provide collaborative, coordinated care in a true multidisciplinary fashion. Moving forward, we will continue to build teams and programs on the solid foundation that is already created. We will be relentless in pursuing Carilion’s mission of improving the health of the communities we serve.

I invite you to explore our website to learn about various programs in clinical care, training and research and welcome your opinion and input to achieve goals of our mission.

 

Aashit K. Shah, MD

Chief of Neurology

Shah

Aashit K. Shah, M.D.

Chief, Neurology

"My goal is to provide comprehensive care for individuals with neurological disorders, including proper diagnosis using advanced imaging and neurophysiological testing and treatment. I strive to use the most appropriate medications and surgical intervention in select cases, in order to give the best chance for patients to live their life without seizures, and with the least side effects of treatment."

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Department specs

Program Size

  • 21 Physicians
  • 7 Advanced Care Providers (ACPs)

Volume of Procedures

  • Annual Encounters (2019): 15,629
  • Annual EEG volume (2019): 4,087
  • Annual volume of thrombectomy procedures (2019): 92
  • Annual volume of inpatient stroke patients (2019): 1,031

Services

  • Epilepsy monitoring unit
  • Neuroimaging & neurophysiological testing (EMG/EEG)
  • Stroke services
  • Ambulatory EEG
  • Botox injections for neurological conditions
  • Continuous EEG monitoring in ICU setting
  • Cortical mapping for eloquent cortex
  • Deep brain stimulation (DBS) programming
  • EEG
  • Evoked potentials
  • ICU EEG monitoring
  • Intracranial EEG monitoring
  • Invasive EEG monitoring
  • Management of Status Epilepticus
  • Sphenoidal electrode placement
  • Surgical treatment of epilepsy
  • Trigger point injections
  • Wada test

Conditions Treated

  • Alzheimer's disease
  • Ataxias
  • Autoimmune encephalitis
  • Brain tumors
  • Cerebral palsy
  • Chronic or severe headaches
  • Dystonia
  • Encephalitis
  • Epilepsy
  • Essential tremors
  • Facial pain
  • Headaches/migraines
  • Hereditary spastic paraplegia
  • Huntingtons disease and other forms of Chorea
  • Illnesses resulting in involuntary movements
  • Medication induced movement disorders
  • Memory disorders
  • Meningitis
  • Movement disorders
  • Multiple sclerosis
  • Myelitis
  • Myoclonus
  • Nervous system infections
  • Neuropathy
  • Parkinson's Disease
  • Pregnancy and neurology
  • Psychogenic movement disorders
  • Restless leg syndrome
  • Seizures
  • Spinal tumors
  • Stroke
  • Syncope & unexplained loss of consciousness
  • Tardive dyskinesia and medication-induced movement disorders
  • Tourettes Syndrome and other tic disorders
  • Transient ischemic attack (TIA)

Areas We Serve

  • Roanoke Valley
  • New River Valley
  • Franklin County
  • Rockbridge County
  • Smith Mountain Lake
  • Bedford
  • Far Southwest Virginia
  • Shenandoah Region
  • West Virginia

Quick Facts

  • A certified MDA/ALS Center: serving as the connection for expert clinical care and medical research.
  • The region's only accredited inpatient epilepsy monitoring unit is at Carilion Roanoke Memorial Hospital.
  • Designated Gold Seal of Approval by The Joint Commission.

Contact and Careers

Contact

Karyn Farrell

kbfarrell@carilionclinic.org

(540) 224-5383

 

Aashit Shah, MD, FAAN, FANA

Chief of Neurology, Carilion Clinic

Professor, Virginia tech Carilion School of Medicine

akshah@carilionclinic.org

(540) 224-5170

Publications

Amyloid spells

Neurology. Clinical practice

A 66-year-old woman presented with a history of recurrent, transient neurologic symptoms including limb shaking, focal paresthesias, focal weakness, dysphasia,...

Updates in Refractory Status Epilepticus

Critical care research and practice

Refractory status epilepticus is defined as persistent seizures despite appropriate use of two intravenous medications, one of which is a benzodiazepine. It can...

Comparing No-Show Rates of Neurology Outpatients with and without Parkinson's Disease: A Real-World Assessment of the Parkinsonian Personality Profile

Research Article

Background:Parkinson’s disease (PD) has been hypothesized to be associated with certain personality traits, including conscientiousness and punctuality. However...

Racial variations in lacosamide serum concentrations in adult patients with epilepsy

Clinical short communication

Lacosamide (LCM) is a third-generation anti-epileptic drug (AED) for partial-onset epilepsy with minimal hepatic metabolism and drug-drug interactions. The impa...

Efficacy of Electrical Stimulation on Nerve Fiber Growth in Small Fiber Neuropathy

To define whether electrical nerve stimulation (ENS) therapy would promote intraepidermal nerve growth and nerve regeneration in patients with small fiber neuro...

Seizure-related injury and postictal aggression in refractory epilepsy patients

In the general population, injury related to seizures often involves falls, head trauma, soft tissue injuries, burns and fractures. Additionally, postictal dele...

Atypical presentation of Lyme neuroborreliosis related meningitis and radiculitis

Lyme disease related central and peripheral nervous system manifestations can occur in isolation or together. Radiculitis or inflammation of the nerve root can ...

Simultaneous involvement of optic and abducens nerves by Lyme disease: Case report with review of the literature

Ocular manifestations of Lyme disease (LD) remain a rare feature of the disease, but it may present a wide range of clinical presentations with different combin...

Dropped head syndrome due to neuromuscular disorders: Clinical manifestation and evaluation

In this article, we discuss the clinical approach to patients with dropped head syndrome and identify the various neuromuscular causes of dropped head syndrome ...

Stereotactic radiosurgery with and without checkpoint inhibition for patients with metastatic non-small cell lung cancer to the brain: a matched cohort study

Immune checkpoint inhibitors (ICIs) improve survival in patients with advanced non-small cell lung cancer (NSCLC). Clinical trials examining the efficacy of IC...

The development of myasthenia gravis in a patient with facioscapulohumeral muscular dystrophy: case report and literature review

The co-existence of facioscapulohumeral muscle dystrophy (FSHD) and myasthenia gravis (MG) is very rare and few cases have been described in the literature. To ...

Delayed diagnosed atypical case of Andersen-Tawil syndrome

Andersen-Tawil syndrome (ATS) is characterized by a triad of periodic paralysis, cardiac arrhythmias and distinctive dysmorphic features. Due to its rarity and ...

Immunoglobulin Treatment in Neuromuscular Medicine

Intravenous immunoglobulin (IVIg) is used in the treatment of autoimmune diseases, including immune-mediated central and peripheral nervous system disorders. Th...

Intravenous Immunoglobulin as a Therapeutic Option for Mycoplasma pneumoniae Encephalitis

Objective: To analyze the outcomes of a cohort of children diagnosed with Mycoplasma pneumoniae encephalitis whose treatment regimens included intravenous immun...

Tolerability of adjunctive eslicarbazepine acetate according to concomitant lamotrigine or carbamazepine use: A subgroup analysis of three phase III trials in adults with focal (partial-onset) seizures

Objective: To evaluate and compare the effects of concomitant lamotrigine (LTG) or carbamazepine (CBZ) on the incidence of treatment-emergent adverse events (TE...

Inadequate benzodiazepine dosing may result in progression to refractory and non-convulsive status epilepticus

Status epilepticus (SE) is defined as ongoing seizures lasting longer than five minutes or multiple seizures without recovery. Benzodiazepines (BZDs) are first-...

Effects of Marijuana on Ictal and Interictal EEG Activities in Idiopathic Generalized Epilepsy

Marijuana-based treatment for refractory epilepsy shows promise in surveys, case series, and clinical trials. However, literature on their EEG effects is sparse...

Hypothalamo-pituitary-adrenal axis after a single epidural triamcinolone injection

Purpose: To quantify adrenocorticotropin and cortisol secretion after epidural glucocorticoid injection.

Signal hyperintensity of the callosum after ventriculoperitoneal shunting

A 66-year-old man underwent ventriculoperitoneal shunting for communicating hydrocephalus. MRI 10 months postoperatively, done for transient headache, showed ne...

Electrodiagnostic findings in myotonic dystrophy: A study on 12 patients

Myotonic dystrophy (DM) is a complex multisystem disease with specific clinical and electrodiagnostic findings. Myotonia can be seen in the distal and proximal ...

Respiratory System, Sleep Quality, Restless Leg Syndrome, and Depression-Anxiety Assessment in Charcot Marie Tooth Disease

No summary available.

Unusual Presentation of Unilateral Isolated Probable Lyme Optic Neuritis

Optic neuritis (ON) is one of the most common manifestations of central nervous system involvement caused by various etiologies. Lyme ON is an exceedingly rare ...

Diagnosis and Surgical Treatment of Drug-Resistant Epilepsy

Despite appropriate trials of at least two antiepileptic drugs, about a third of patients with epilepsy remain drug resistant (intractable; refractory). Epileps...

Our Technology

Carilion Clinic is First in Virginia to Offer DBS for Epilepsy.

Research

We stay on the forefront of neurology treatment by being involved in research. By being involved in clinical trials and staying updated on the latest treatment options, our patients know they are getting the best possible care, right here at home.

Contracts, Grants and Sponsored Research

Federally funded grants:

  1. Co-PI: Shah, A. K., SCH:INT: Collaborative Research: Semi-Automated Rehabilitation in the Home. Awarded 2020; August 15, 2020 - July 31, 2024, (2 % effort), National Science Foundation, $1,100,000.00

Clinical Trials

  1. Shah, A.K. (Principal Investigator), Anyanwu, C.O. (Co-Investigator), “Phase I, Open-Label Study of Carisbamate in Adult and Pediatric Subjects with Lennox-Gastaut Syndrome,” Sponsored by SK Life Science, Inc., Industry.  (September 11, 2019-present).
  2. Shah, A.K. (Principal Investigator), Anyanwu, C.O. (Co-Investigator), “YKP3089CO25, PGTC, Double-Blind, Randomized, Placebo-Controlled, Multi-Center Study to Evaluate the Efficacy and Safety of Cenobamate Adjunctive Therapy in Primary Generalized Tonic-clonic Seizures, “ Sponsored by SK Life Sciences, Industry, $75,891.00. (March 11, 2019- Present).
  3. Shah, A.K. (Principal Investigator), Anyanwu, C.O. (Co-Investigator), “A Randomized, Double-blind, Placebo-controlled, Multicenter Study to Evaluate the Safety, Tolerability and Efficacy of XEN1101 as Adjunctive Therapy in Focal-onset Epilepsy,” Sponsored by Xenon Pharmaceuticals Inc., Industry, $109,402.00 (August 28, 2019- August 28, 2022)
  4. Shah, A.K. (Principal Investigator), Anyanwu, C.O. (co-Investigator), “A Double-Blind Placebo-Controlled, Inpatient, Dose-Ranging Efficacy Study of Staccato Alprazolam (STAP-001) in Subjects with Epilepsy with a Predictable Seizure Pattern,” Sponsored by ENGAGE Therapeutics, Industry, $101,930.90 (January 14, 2019-January 14, 2020).

RAP-Grant

  1. Shah, A.K. (Principal Investigator), Anyanwu, C.O. (Co-Investigator), “Effect of opioid administration in frequency distribution and phase coupling in various human brain regions—Opioids and intercranial EEG (iEEG) study”, Sponsored by Carilion Clinic RAP15 Grant funding, Foundations, $12,360.00 (June 18, 2019-May 30, 2021).
  2. Shah, A.K. (Principal Investigator), Mittal S. (Co-PI), “Study of Neurofilament Light Chain (NfL) as a Biomarker for Seizure Induced Neuronal Injury—A Translational Approach”, Sponsored by Carilion Clinic RAP Grant funding—RAP16, Foundations, $26,000.00. (September 2020-).

iTHRIV Pilot Translational and Clinical Studies Grant:

  1. Shah, A.K. (Principal Investigator), Vijayan S (Co-PI), Anyanwu, C.O. (Co-Investigator), Effects of various neuroactive drugs on frequency distribution and phase coupling in various human brain regions-Neuroactive drugs and Intracranial EEG (iEEG) study. Direct cost $45,598 (Sept 2020- March 2022)

Investigator Initiated Study:

  1. Shah, A.K. (Principal Investigator), Anyanwu, C; Witcher M (Co-Investigators), “Correlation of Serum level of Perampanel (PER) level of Cerebrospinal Fluid (CSF) Levels of PER,” Sponsored by Eisai Co, Ltd, Industry, $142,370.90 (January 1, 2019-December 31, 2021).

Nonfunded and Resident led research:

  1. Principal Investigator: Shah, A. Co-Investigator: Mohammad, N., Propensity score matched analysis of coccidioidomycosis patients with and without meningitis. January 2020 - 2022, (0 % effort). Additional Information: IRB-19-688
  2. Principal Investigator: Shah, A. Co-Investigator: Dabiri, I. The Outcome of Onabotulinum toxin A Treatments on Depression, Anxiety, and Impact of Life in Patients with Chronic Migraine. IRB # 2751.
  3. Principal Investigator: Gowda, S. Co-Investigator: Shah, A. K. Neurological prognostic indicators in Hypoglycemic coma
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Education

Overview

The Adult Neurology Residency Training Program is central to our departmental mission and closely integrated into our clinical and research programs. Our faculty is eager to provide a supportive learning environment—one characterized by mutual respect, constructive feedback and a commitment to lifelong learning.

Approved by the ACGME in June of 2015, our four-year program enrolls three trainees each year. Though new, our program offers many advantages to its residents. Our size allows the house staff and faculty to work hand-in-hand in all clinical settings. Our faculty—both at Carilion Clinic and the Salem Veteran’s Administration Hospital facilities—have many years of teaching experience at university medical centers and a proven track record in resident mentorship. Our hospitals and clinics serve diverse urban and rural communities, and our patients present challenges that are both complex and inspiring.

We aim to help our residents meet neurology’s challenges through rigorous clinical training, fostering a balance between supervision and autonomy, maximizing each trainee's full potential, and by preparing our residents fully for the independent practice of clinical neurology. Our curriculum also establishes a solid foundation for those who wish to pursue additional career interests, such as subspecialty fellowship training, biomedical research and neurological advocacy.

For information, visit our Neurology Residency page by clicking here.