Neurology

Neurology

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

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PROF.K. MUGUNDHAN

professor

Prof. Dr. K. Mugundhan MD, DM (Neurology) Director and Professor of Neurology at the Institute of Neurology, Madras Medical College. He has been practicing in the field of Neurology since 2006 with a strong commitment to clinical care. His areas of interest include epilepsy, stroke, and demyelinating disorders. He is known for his excellent administrative skills. He is also deeply passionate about clinical teaching and mentoring young medical professionals.

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PROF.N.THAMILPAVAI

professor

Prof. Dr. N. Thamil Pavai MD, DM (Neurology) Professor of Neurology at the Institute of Neurology, Madras Medical College. Member of IAN, IEA ,MDSI & IHS. Areas of interest movement disorders & cognitive neurology. ICMR Projects : 1) As a CO–PI in All India Multiple Sclerosis Registry. 2) As a CO–PI in Profile of Neuronal Damage based on clinical, immunological, imaging and spectroscopic alterations in patients recovered from SARS-CoV2 infection - A Cohort Study.

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PROF. R. VIVEKASARAVANAN

professor

Prof. Dr. Viveka Saravanan MD, DM (Neurology) Professor of Neurology at Institute of Neurology, Madras Medical College. Experienced neurologist with a strong commitment to clinical care and academic excellence. Areas of interest include general neurology, neuroimmunology and epilepsy. Passionate about clinical teaching and mentoring, with a proven track record of guiding medical trainees and fostering professional development.

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PROF.N.SHANMUGASUNDARAM

professor

Prof. Dr. N. Shanmuga Sundaram MD, DM (Neurology) Professor in Institute of Neurology, Madras Medical College. He has been practicing in the field of Neurology with areas of interest in general neurology, demyelinating disorders and electrophysiology. He is also deeply passionate about clinical teaching and mentoring young neurologists.

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DR. E. UMA MAHESHWARI

Assistant Professor

Dr. E. Uma Maheswari MD, DM (Neurology) Assistant Professor in Institute of Neurology Madras Medical College. She has been practicing in the field of Neurology since 2013. Her areas of interest are demyelinating disorders and CNS Tuberculosis She is also a co-principal investigator in ICMR Project - IN SHORT TB Meningitis trial and TBM Registry.

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DR.L.A.RAVI

Assistant Professor

Dr. L. A. Ravi MD, DM (Neurology) Assistant Professor in Institute of Neurology, Madras Medical College. He has been practicing in the field of Neurology since 2014 with a strong commitment to clinical care. His areas of interest include epilepsy, stroke, and demyelinating disorders. He is also deeply passionate about clinical teaching and mentoring young medical professionals.

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DR.A.MARIAN JUDE VIJAY

Assistant Professor

Dr. A. Marian Jude Vijay MD, DM (Neurology) Assistant Professor in Institute of Neurology, Madras Medical College. He has been practicing in the field of Neurology since 2014. His areas of interest include epilepsy, stroke, demyelination and electrophysiology.

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DR.V.NANDAKUMAR

Assistant Professor

Dr. V. Nandakumar MD, DM (Neurology) Assistant Professor in Institute of Neurology, Madras Medical College. He has been practicing in the field of Neurology since 2016. He is CO–PI for ICMR Project – Hospital based stroke registry. His areas of interest include pediatric neurology and demyelinating disorders.

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DR. E. NATARAJAN

Assistant Professor

Dr. E. Natarajan MD, DM (Neurology) Assistant Professor in the prestigious institute of Neurology, Madras Medical college. He has immense interest in clinical neurology. His other areas of interest include movement disorders, stroke care and neuromuscular disorders.

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DR.V.RAJAGEMBEERAN

Assistant Professor

Dr. V. Rajagembeeran MD, DM (Neurology) Assistant Professor in the prestigious institute of Neurology, Madras Medical college. He areas of interest include neurosonology, pediatric neurology, stroke and epilepsy.

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DR.A.VIGNESH

Assistant Professor

Dr. A. Vignesh MD, DM (Neurology) Assistant Professor of Neurology at Institute of Neurology, Madras medical College. He is a dedicated neurophysician who has been practicing Neurology since 2017. He has also got his Speciality certification in Neurology in 2018. Since then, he is working as faculty of neurology and is passionate about teaching and developing clinical skills.

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DR.V.PRAKASH

Assistant Professor

Dr. V. Prakash MD, DM (Neurology) Assistant professor of Neurology in Institute of Neurology, Madras Medical College with expertise in stroke treatment and neurocritical care. He is practicing in the field of neurology since 2024. He is passionate about improving lives through comprehensive neurological care.

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DR.SENTHIL KUMAR

Assistant Professor

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DR.SHYLAJA

Senior Residents

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DR.AUBIN MATHEW

Senior 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
2 DR.JUHINA DR.BHANU SRINIVAS YADLAPALLI DR.BHAVANA
3 DR.KARTHIKEYAN DR.DILIP KUMAR. V DR.BRINDHA ANDAL
4 DR.MANOJKUMAR DR.DIVYAPRABHA DR.DAYASAGAR REDDY
5 DR.NAREN POLAVARAPU DR.NAVANEETHA KRISHNAN DR.DEEPTHI P
6 DR.NAVEEN PRIYADHARSAN DR.NITHYA DR.HARINI M
7 DR.RAJ GOKUL DR.PARTHASARTHI DR.JAYASHREE
8 DR.ROSY THOMAS DR.RAGUL SEN. S DR.KARTHICK RAJA S
9 DR.G.SAIPRAJNA DR.SATHEESH DR.POOJA SWETHA
10 DR.SANTHOSH KUMAR DR.SEETHALAKSHMI. N DR.PRAMEETHA RAJAPPA
11 DR.SHINY THOMSON DR.SHINY MISPA MERIN. P DR.SAI PRANAVI
12 DR.SOORYA UNNI DR.SIVARANJINI DR.VISHNU PRADEEPAN
13 DR.G.TAMILKUMARAN DR.VASU DARUVURI DR.KARTHICK RAJA S
14 DR.VIGNESHKUMAR DR.JAYASHREE

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 Related Images
1 30th July 2024 Approach to falls in elderly Prof.V.Chandramouleeswaran Institute Level

Renew , Rejoice - CME on renal transplantation


CME / CONFERENCE
S.NO Date CME / CONFERENCE – Title University / TNMSC Credits / both if present State or National level or institute level Related Images
1 6th & 7th July 2024 TAN PG Exam prep course in Neurology 10 Credit points National Level

Renew , Rejoice - CME on renal transplantation


POST GRADUATE TRAINING PROGRAMME
S.NO Date Noon Sessions Morning session State or National level or institute level Related Images
1 Monday Case presentation Clinical rounds and Ward discussion

Renew , Rejoice - CME on renal transplantation


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 Related Images

Renew , Rejoice - CME on renal transplantation


Other Events
S.NO Date Other events with Title Details Related Images

Renew , Rejoice - CME on renal transplantation


Scientific Forum

Completed Projects
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Ongoing Projects
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Sponsored Projects
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Publications
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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
2 15/08/2020 Editor of a book (South Asian Edition of Localization in Clinical Neurology - Paul W. Brazil) Dr. R. Lakshmi Narasimhan Institute No Image
3 15/08/2020 Editor of a book ( South Asian edition of Practical Neurology - Jose Biller) Dr. R. Lakshmi Narasimhan Institute No Image
4 15/08/2020 Presidential gold medal in DNB exam Dr. R.Guhan National No Image
5 15/08/2020 The Lalgudi Dr Sumathi Natarajan University Gold medal Dr. Shrivarthan State No Image
6 15/08/2020 FIMSA Dr. A.Nithyanandam Institute No Image
7 15/08/2020 Prize for best paper in TANCON(Correlation of nerve ultrasound in CIDP) Dr. Guruprasad State No Image
8 15/08/2020 1st prize in platform presentation in TANCON (Cognitive impairment in MS) Dr. Esther State No Image
9 15/08/2020 2nd prize in platform presentation in TANCON (Correlation of LFTs with autonomic dysfunction in GBS patients) Dr. Sanjeev State No Image
10 15/08/2021 Shefali sanjai Jain university medal for Neurology Dr. Shrivarthan State No Image
11 15/08/2021 1st prize in TANCON quiz competition Dr. Nirumal Khumar Dr. Srividhya State No Image
12 15/08/2022 FRCP(London) Dr. V. Chandra Mouleeswaran Institute No Image
13 15/08/2020 Shefali Sanjai Jain university medal for neurology Dr. Aravind Ghautham State No Image
14 08/07/2023 FRCP(London) Dr. S. Balasubramanian Institute No Image
15 08/07/2023 FRCP(Eidenburg) Dr. S. Velusamy Institute No Image
16 08/07/2023 FRCP(London) Dr. A. Nithyanandam Institute No Image
17 08/07/2023 FRCP(Glasgow) Dr. A. Nithyanandam Institute No Image
18 08/07/2023 Indian Academy of Neurology(Maximum number of research papers) Institute of Neurology, Madras Medical College National No Image
19 08/07/2023 1st prize for platform presentation – Intenational Stroke Conference Dr. Tejaswini Durgam National No Image
20 08/07/2023 1st prize in quiz (KAN Monsoon summit) Dr. Nirumal Khumar Dr. Noel James State No Image

Success Stories

1 Success stories
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  • 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
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  • 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
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  • 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.

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