PROF.K. MUGUNDHAN
Professor
History
- Rajiv Gandhi Government General Hospital, Chennai is a component institution of the Madras Medical College and is two centuries old.
- Institute of Neurology was started in 1950 as a combined Institute of Neurosciences.
- Neurology as a super-speciality was the first neurology department in India, initiated by Prof. G. Arjundas and Prof. K. Jagannathan.
- Neurological sciences as a functioning super-speciality was started by Prof. B. Ramamurthi on October 1950 on a Vijayadasami day, with 4 beds.
- The Institute was bifurcated into the Institute of Neurology and the Institute of Neurosurgery in 2015, with separate directors to enhance academic activities and patient care.
- Prof. K. Bhanu was the first Director of the Institute of Neurology, succeeded by Prof. S. Gobinathan and Prof. R. Lakshmi Narasimhan. The Institute is currently headed by Prof. Dr. S. Balasubramanian.
- The first DM Neurology candidate in India was trained at our Institute.
- Ours is the first institute in the country to offer the MCh Neurosurgery course.
- The new disease entity "Madras Motor Neuron Disease" was first described in our Institute by Meenakshisundaram E, Jagannathan K, and Ramamurthi B in 1970.
- In 1952, Neuroradiology was started.
- In 1957, Electroencephalography was introduced, and in 1962 a full Neurology unit was inaugurated.
- In 1966, the PhD Programme and DM Neurology course were initiated.
- In 1967, the Neuro Ophthalmology department was started.
- In 1968, the foundation stone for a separate building of the Institute of Neurology was laid.
- In 1970, the Neuropathology department was established.
- In 1972, the Institute of Neurology was officially declared open.
- In 1975, the Silver Jubilee celebration was conducted.
- In 1977, DM Postgraduate seats were increased to 5.
- In 1980, the CT Scan was commissioned.
- In 1983, Speech Therapy was started.
- In 1984, Evoked Potential study was introduced.
- In 1990, the Headache Clinic was started.
- In 1991, the Epilepsy Clinic was initiated.
- In 1993, the NSI Annual Conference was organized.
- In 1997, the 5th Annual Conference of the National IAN was organized.
- In 1998, the Movement Disorder Clinic was started.
- In 2000, the Golden Jubilee Celebration of the Institute was conducted.
- In 2008, the Golden Jubilee Celebration of the Neurology Department was celebrated.
- In 2010, DM postgraduate seats were increased to 14.
- In 2012, the Stroke Ward was inaugurated.
- In 2012, the first IV Thrombolysis for Acute Ischemic Stroke in a government institution in our state was started in our institute.
- In 2020, BSc Electrophysiology courses with 10 students were started.
- In 2021, the Gait Lab was started.
- In 2022, Video Nystagmography was introduced.
- In 2022, the Stroke ICU was started.
- In 2023, the Autonomic Function Lab was instituted for the first time in a government institute in our state. It was inaugurated by the Honourable Minister of Health and Family Welfare.
Faculty & Residents
| S.No | Name of the Residents joined in the year 2022 | Name of the Residents joined in the year 2023 | Name of the Residents joined in the year 2024 |
|---|---|---|---|
| 1 | DR.BHARATH | DR.ABINAYA | DR.ANASWARA.S.MANI |
Facility & Clinical Care
OUTPATIENT STATISTICS
| S.no | Monthly | Yearly | |
|---|---|---|---|
| 1 | Neurology OPD | 6,753 | 74,890 |
| 2 | Speciality Clinics | ||
| 3 | Epilepsy Clinic | 2,760 | 32,684 |
| 4 | Headache Clinic | 231 | 2,342 |
| 5 | Movement Disorders | 190 | 1,601 |
| 6 | Nerve and Muscle | 42 | 395 |
| 7 | Demyelination | 26 | 317 |
| 8 | Dementia | 15 | 227 |
| 9 | Stroke | 270 | 2,568 |
INPATIENT STATISTICS
| S.no | Monthly | Yearly | |
|---|---|---|---|
| 1 | Inpatient | 570 | 6,833 |
- Bed Strength:
- Total: 170
- Neuro ward: 103
- Stroke ward: 37
- Stroke ICU: 6
- Neuro Respiratory ICU: 12
- General Neurology ICU: 12
- Diagnostic Facilities:
- EEG (Electroencephalograph)
- Video EEG
- Bed side EEG
- NCS (Nerve Conduction Study)
- EMG (Electromyography)
- Video Nystagmography
- Gait Analysis Equipment
- Autonomic Nervous System LAB
- Transcranial Doppler
- Polysomnography
- In Patient Care Facilities:
- Separate ICUs for Stroke, General Neurology, and Neuro-respiratory disorders.
- Ventilator support for critically ill patients with poor GCS and respiratory failure.
- Multipara Monitors for 24/7 ICU patient monitoring.
- Infusion Pumps for insulin delivery, ionotrope support, and antihypertensive infusion.
- Alpha Beds for critically ill and stroke patients to prevent bedsores.
- Commonly Treated Neurological Diseases:
- Acute Ischemic Stroke
- Acute Hemorrhagic Stroke
- Infections:
- Acute encephalitis, Meningitis, Meningoencephalitis
- Chronic meningoencephalitis – TB, Fungal, Parasitic, Others
- Demyelinating Diseases: Multiple Sclerosis, ADEM, NMO, MOG
- Neuromuscular Diseases: GBS, CIDP, Myasthenia Gravis, Myopathies, Neuropathies, Anterior Horn Cell Diseases
- Autoimmune Diseases: Central and Peripheral
- Degenerative Diseases: Dementias, Parkinson’s Disease, Parkinson Plus Syndromes, Ataxias
- Metabolic, Nutritional, Endocrine Neurological Diseases
- Toxic Neurological Disorders
- Tumors, Traumatic Lesions
- Spinal Cord Disorders
- Neuro-psychiatric Disorders
- Duty Neurophysician Services:
- 24 hours neurophysician services available
- 24/7 inpatient call-overs attended
- Consultations for general medical, surgical, and specialty wards including Cardiology, GE, Nephrology, etc.
- Neurology services for pregnant mothers – call overs from IOG, KGH attended 24/7
- Neurology services for allied institutions – ICH, IMH attended 24/7
- Other Services:
- Master Health Services
- Disability Certification
- Makkalai Thedi Maruthuvam
- High End Treatment:
- IV Thrombolysis for Ischemic Stroke
- Plasmapheresis for autoimmune and demyelinating disorders
- IV Immunoglobulin therapy for autoimmune and demyelinating disorders
- Botulinum Toxin Injection for movement disorders (dystonia, hemifacial spasm, spastic paralysis)
- Treatment for Multiple Sclerosis: Interferon Beta, Other Oral Drugs
- Inj. Rituximab for Immunological Diseases
- Speciality Clinics:
- Daily: Epilepsy Clinic – Monday to Saturday
- Weekly:
- Mondays: Demyelination Clinic
- Tuesdays: Movement Disorder Clinic
- Wednesdays: Neuromuscular Clinic
- Thursdays: Dementia Clinic, Headache Clinic
- Fridays: Stroke Clinic
- Thrombolysis Statistics: Yearly – 33 (2024)
- Plasmapheresis: Yearly – 39 (2024)
- IV Immunoglobulin: Yearly – 70 (2024)
Academic Forum
SEMINAR / SYMPOSIUM
| S.NO | Date | Seminar and Symposium with Title | Presentor & moderators with their designation | State or National level or institute level | University / TNMSC Credits / both if present |
|---|---|---|---|---|---|
| 1 | 30th July 2024 | Approach to falls in elderly | Prof.V.Chandramouleeswaran | Institute Level |
CME / CONFERENCE
| S.NO | Date | CME / CONFERENCE – Title | University / TNMSC Credits / both if present | State or National level or institute level |
|---|---|---|---|---|
| 1 | 6th & 7th July 2024 | TAN PG Exam prep course in Neurology | 10 Credit points | National Level |
POST GRADUATE TRAINING PROGRAMME
| S.NO | Date | Noon Sessions | Morning session | State or National level or institute level |
|---|---|---|---|---|
| 1 | Monday | Case presentation | Clinical rounds and Ward discussion |
Quiz /competitions
| S.NO | Date | Quiz /competitions with Title | University / TNMSC Credits / both if present | Prizes awarded to | a. Inter or Intra – Collegiate Level b. State or National level |
|---|---|---|---|---|---|
Other Events
| S.NO | Date | Other events with Title | Details |
|---|---|---|---|
Scientific Forum
Awards & Achievements
| S.NO | Date/Month & Year | Name of the Awards & achievements received | Name of the awardee with designation | District level / State level / National level | Images |
|---|---|---|---|---|---|
| 1 | 01/01/2020 | Editor of a book (South Asian Edition of Localization in Clinical Neurology - Paul W. Brazil) | Dr. R. Lakshmi Narasimhan | District | View |
Success Stories
1 Success
stories
- Mr. Moorthy, a 38-year-old gentleman with Thymomatous Myasthenia Gravis presented with high-grade fever and cough for three days.
- He developed drooping of both eyelids, difficulty swallowing, slurred speech with nasal twang, breathlessness, and limb weakness.
- Patient was admitted under the N2 unit.
- On examination, he had bilateral ptosis with normal extraocular movements and pupils 3mm in size, equally reacting to light.
- Fatigability was present with normal power in all four limbs. Single breath count was six, and vitals were stable.
- A diagnosis of Myasthenic Crisis was made. Due to impending respiratory failure, the patient was intubated and ventilated.
- Plasmapheresis was initiated and five cycles were completed, but the clinical condition remained static.
- During treatment, patient developed right lower lobe consolidation and was started on appropriate antibiotics.
- In view of prolonged ventilation, tracheostomy was performed.
- Clinical condition improved partially but patient could not be weaned off the ventilator.
- Repeat chest imaging showed resolution of infection. IV Immunoglobulin (25g/day for 5 days) was started for persistent Myasthenic Crisis.
- Despite IVIG, there was no significant improvement. Patient developed fever and desaturation requiring higher FiO2 delivery.
- Blood culture revealed Pseudomonas sepsis, treated with appropriate antibiotics.
- Due to refractory Myasthenic Crisis, Rituximab was initiated as per protocol.
- Chest physiotherapy and total parenteral nutrition were provided.
- After Rituximab therapy, patient improved and was weaned off the ventilator with anesthetist assistance.
- Patient remained under neurological care for 6 months and was discharged with intermittent oxygen support.
- During follow-up OPD visit, patient arrived walking and was asymptomatic.
- He is under continued follow-up and is being planned for thymectomy.
2 Success
stories
- Miss Uma Maheshwari, a 19-year-old female, presented with headache and high-grade fever for 5 days followed by focal seizures with secondary generalisation.
- She was initially taken to CMC Vellore and started on anti-seizure medications.
- Due to status epilepticus and low GCS, she was intubated and placed on ventilatory support.
- As seizures persisted, multiple IV anti-seizure medications were administered.
- She was referred to MIN and admitted under the N3 unit for further management.
- Patient was started on injection midazolam, and due to refractory seizures, thiopentone infusion was subsequently initiated.
- Reduced air entry was noted in the left mammary area; chest X-ray showed left-sided pneumothorax, for which left-sided ICD was inserted.
- CSF analysis revealed normal cell count and protein; MRI Brain showed nonspecific T2 hyperintensities.
- IV methylprednisolone pulse therapy was given initially, leading to a reduction in seizure frequency. Thiopentone was tapered and stopped; midazolam infusion was continued.
- Autoimmune encephalitis panel was negative; clinical diagnosis of seronegative autoimmune encephalitis was made.
- Plasmapheresis (5 cycles) was initiated; due to no clinical improvement, IV Immunoglobulin (0.4 mg/kg/day) was given for 5 days.
- As seizures settled, midazolam infusion was tapered and stopped; anti-seizure medications were continued.
- She developed bronchopneumonia with Pseudomonas infection, treated per culture sensitivity.
- Grade III bedsores developed and were managed with wound debridement.
- Intermittent right focal seizures recurred; midazolam infusion was restarted.
- She developed autonomic dysfunction (BP fluctuations, persistent tachycardia) and watery diarrhea.
- In view of refractory autoimmune encephalitis, injection rituximab was started as per protocol.
- Clinical improvement was noted and the rituximab course was completed.
- She developed right lower limb DVT, which was managed with anticoagulants.
- Following rituximab, sensorium improved and seizures subsided; she was weaned off the ventilator and started on oral feeds.
- After 6 months of ICU stay, she was shifted to the general ward; rehabilitative measures and psychiatric counselling were initiated.
- She was discharged with anti-seizure medications and followed up regularly.
- During follow-up visits, she walked with a walking aid initially; later, she walked independently.
- She was able to perform simple calculations and is set to join her engineering course in the upcoming academic year.
3 Success
stories
- Mr. Mohan Raj, a 50-year-old gentleman, was admitted with sudden onset weakness of the right upper and lower limbs for the last 2 hours on 13/06/2023.
- He is a known case of Diabetes Mellitus (11 years) and Systemic Hypertension (5 years) on regular treatment.
- History includes peripheral vascular disease, left little toe amputation 2 years ago, right foot ulcer with forefoot amputation, and right lower limb peripheral angioplasty done on 09/02/2023.
- He is a chronic smoker and alcoholic.
- Weakness started when he attempted to hold his mobile phone, which he dropped; he then noticed slurred speech when trying to call his wife.
- Required assistance from two people to get into an auto rickshaw to reach the hospital.
- Admitted under the N1 unit in the stroke ICU.
- On examination: right hemiparesis with power grade 1/5 in both right upper and lower limbs and facial weakness. NIHSS score was 12.
- Stroke protocol initiated; CT brain showed ASPECTS score of 10.
- Patient arrived within the window period and was thrombolysed with Injection Alteplase after ruling out contraindications as per institutional protocol.
- Vitals were monitored during thrombolysis; post-thrombolysis period was uneventful.
- MRI Brain (next day) showed T2/FLAIR hyperintensity in left ganglio-capsular region and corona radiata with diffusion restriction, suggesting acute infarct.
- Carotid-vertebral doppler showed calcified plaque in the right carotid bulb with no significant extracranial stenosis.
- Transcranial doppler showed no significant increase in mean velocity in affected intracranial vessels.
- Patient was started on statins, antihypertensives, and injection human insulin.
- Aspirin was started 24 hours after thrombolysis.
- Patient was advised to stop smoking and alcohol.
- Vascular surgery opinion was obtained; Injection Unfractioned Heparin 5000 IU s/c every 6 hours for 5 days was administered for peripheral vascular disease.
- Cardiology opinion obtained: Echocardiogram showed concentric LVH with normal ejection fraction.
- Rehabilitative physiotherapy for limbs was initiated.
- Power improved, and the patient became symptomatically better.
- Patient was discharged ambulatory and is currently on follow-up in the Neurology OPD.
Others
No Others information available for this department.
Guests Lectures
No Guest lecture information available for this department.