::Departments : MEDICAL SPECIALITIES : NEUROLOGY

History

Jean-MartinCharcot (1825 - 1893) was a French neurologist and professor of anatomicalpathology. He is known as "founder of modern neurology" and isassociated with at least 15 medical eponyms", includingCharcot-Marie-Tooth disease and amyotrophic lateral sclerosis (Lou Gehrig'sdisease). Charcot has been referred to as "the father of French neurologyand one of the world's pioneers of neurology".


 Dr.S.Saravanan MD DM
Professor & Head

Welcome, It is pride to head thefirst sub-specialty department in TVMC. We came into existence as a departmentin 1989. Under the stewardship of Dr.S.Ganesan, the department was started as aOP which operated twice a week. We now have special OPDs and Neurophysiologyservices. It has since grown to become a Postgraduate Specialty Department oneof the four in the state that trains residents in DM Neurology.



List of Succession of the Department
 
NAME FROM TO
 
DR. S.GANESAN (I/C) 1989 1995
DR. A.IYYATHURAI 1997 1999
DR. S.NATESAN 1999 2001
DR. S.PRABHAKARAN 2001 2002
DR. S.NATESAN 2002 2004
DR. CHANDRASEKARAN 2004 2006
DR. M.ALEEM 2007 2009
DR. B.SREETHARAN 2009 2011
DR. S.SARAVANAN 2011 -

ACADEMIC PROGRAM - DOCTORATE OF MEDICINE (D.M)IN NEUROLOGY

1. BASIC NEUROSCIENCE TRAINING PROGRAM

  • Neuroanatomy : Knowledge of anatomy of the   nervous system including genetics malformation of the nervous system. Conventional descriptive anatomy, systemic anatomy, regional anatomy, cross sectional anatomy (relevant to X-ray Tomography C.T. Scan, Magnetic Resonance Imaging etc.) and also three dimensions anatomy of various operative approaches to the Central Nervous System, including micro-surgical anatomy will form the content of the Neuroanatomy
  • Neurophysiology - detailed knowledge of Physiology of the nervous system including cerebral blood flow and CBF dynamic electrophysiology (EEG, Nerve Conduction studies, KMG, Evoked Potentials) including all the recent advances such as Brain Mapping and Multi-modality Evoked Potentials such as BAER = (Brainstem) SSEP, VEP Cranial and peripheral nerve stimulation - Preoperatively and intraoperatively. A minimum working knowledge of handling the instrumentation and interpretation of different results will be insisted upon
  • Neuro Biochemistry: General Principles of Neurochemistry with special reference to normal tissue constituents, neurotransmitter, neuroreceptology and neurooncology, neurochemical aspects of neurological and neurosurgical illnesses, biochemistry  of tumour of the central nervous system including tumour markers, neurochemical aspects of head injuries and spinal cord injury. MR and MR spectroscopy etc. a minimum working knowledge of interpretation of common  laboratory results will be insisted upon.
  • Neuropathology: General Pathology of nerve cells, neuroglia, blood vessels, cranial and peripheral nerves and their mechanisms, patho-physiology of birth injuries, concussion, contusion, intracranial haematoma, haemorrhages, cerebral oedema, intracranial hypertension. Vascular injuries infective complications, sequels of head injuries etc. Pathology of infections, disease of the nervous system with special reference to Postmeningitic sequelae, vascular, nutritional and metabolic toxic disorders of the nervous system. Aneurysms and angiomatous (arteriovenous) malformations, pathology of brain and spinal card tumours and peripheral nerve tumours including tumours of pituitary, pineal gland and spinal column in detail with special reference to histogenesis, gross pathology, micropathologic aspects, microscopic appearances tissue culture, special diagnostic procedures including cytology techniques. Immunology of brain tumours including current concepts in monoclonal antibodies and targeting  for diagnosis and therapy. The pathology content will include also minimum bacteriology, minimum microbiology, including virology and parasitology with special reference to agents that effects the nervous system in our area/country.
  • Neuro - Microbiology and Immunology- with special reference to the various neurological disorders.
  • Neuro genetics: Normal as well as the abnormalities in different genetically Inherited neurological disorders.
  • Biostatistics and clinical epidemiology : Fundamentals of biostatistics, ability to conduct a clinical trial independently and interpret the final reports.
  • Neuro Pharmacology: The candidate should have a detailed pharmaceutical knowledge of the various aspects of the drugs and pharmaceuticals commonly used in disinfectants, antibiotics, anticonvulsants, anti-oedema measures such as diuretics, antidepressants, analgesics, antipyretics, and antiparkinson, chemotherapy drugs, antipsychiatrics, cardio-vasoactive respiratory supportive drugs including drug assay, monitoring drug inneraction protocols of clinical trials etc.

2. CLINICAL NEUROSCIENCES TRAINING PROGRAM

  • The candidate should have a detailed working knowledge of clinical examination of the neurological/neurosurgical patient including neonates and infants and unconscious patients. A thorough knowledge of the Physical signs including their neuroanatomical and neurophysiological  basis, brief historical vIgnettes, methods of elicitation, interpretation and inference including fallacies  knowledge of various coma scales and their relatives merits and deficits, a detailed knowledge of the evaluation of the Physical signs during various developmental stages, details regarding Brain Death (Cerebral death and brainstem death) etc. are all essential.
  • A detailed knowledge of the differentiation of some common medical neurological disorders which can closely mimic neurosurgical conditions is essential Eg., Microcephaly Vs. Craniosynostesis; Cervical spondylyosis Vs. Anterior Horn Cells Disease, Medical Dementia Vs. N.P.H. etc. A working knowledge of the various medical neurological disorders, particularly more prevalent in our region, is also required. A minimum working knowledge of neurodegenerative disorders, neuro-muscular disease, genetic diseases, paroxysmal disorders etc. is a must.
  • A detailed working knowledge of the various diagnostic procedures including a historical vignette, the instrumentation/equipment, methodology, documentation and interpretation of results will be required. A thorough knowledge of choice of the investigative procedure in a given patient - Decision making in Neurodiagnostics -- is also essential. The candidate should have a reasonable understanding of the stroke, complications fallacies, cost-effectiveness etc. of the various neurodiagnostic procedures.
  • The neurodiagnostic procedures in this context would include access to various parts of the CNS including ventricles, subarachnoids space, neurovasculature, neural parenchyma etc. in the course of Neuro-opthalmological neuro-etiological workup, L.P. V.P. cisternal Tap, EEG, Nerve conduction studies, EMG, electrocorticography, neuroradiology including plain x-rays, x-ray tomography, angiography including venography and venous sinography, Pneumoencephalography, ventriculography, myelography, cisternography, cyscography, orbitography, interventional radiology, radioneculoide angiography, encephalography, and    neuroscintigraphy, ultrasonography   (neonates,     infants,  transcranial intraoperative and interventional), C.T. scanning, MR Imaging including MR angiography and cisternography etc. The candidate should have adequate hand-on experience with the various investigative procedures of day-to-day use.

Program schedules

Ist YEAR : During the first year, the residentwill be working full time in the Department of Neurology. In the morning time,they familiarize the process and nuances of clinical neurology, neurologicalexamination, localization and differential diagnosis, relevant laboratory andradiological investigations and pharmacotherapeutics. They attend all theoutpatient services and get themselves aware of the common neurologicalproblems. In addition, they work in the electrophysiology laboratories and getfamiliar with EMG, evoked potential and electroencephalography (EEG). Theyhandle the equipments and report initially under supervision and thenindependently. They shall undertake basic sciences training & researchstudy within three months after admission.
II YEAR :
The resident is sent to the best centres for additionaltraining. This comes under special postings. The total period is for threemonths or four months depending on the centre. The resident undergoes specificpointed training in Neuro-Ophthalmology, Neuro-Otology, Neuro-Psychiatry, NeuroRadiology, Pediatric Neurology and Intensive Care.
III YEAR: During the period, the resident is back in the Neurologydepartment concentrating on clinical and theoretical neurology, investigationsand medical and para medical management of the patients. Besides, they nowhandle and report the EEG and EMG by themselves. Our Teaching Program involvesdaily discussions, ward rounds, Neuro Meets on every Thursday, Special updateprogrammes on recent advances, Journal Club, Symposium and workshops and Grandrounds.


Hospital Services:The department OF Neurology is wellentrenched in the fields of management of Stroke, especially Acute stroke care,Epilepsy diagnosis and management, diagnosis and management of Movementdisorders, Electrophysiology studies like EEG, EMG and Nerve Conduction &Evoked Potentials, and Autonomic Tests. The department has special clinics forHeadache, Epilepsy, Stroke, Movement Disorders etc. The department takes goodpride in its comprehensive, updated neurodiagnostic facilities which include:Electroencephalography, Brain mapping, Electromyography, ComputerisedTomography, Magnetic Resonance Imaging including Diffusion and Perfusionimages, MR Angiography, MR Venography, MR Myelography, Pathology Biochemistryand Microbiology services.
DEPARTMENT STATISTICS
 
  2007 2008 2009 2010
OPD 34502 36331 36982 37142
Inpatient Admissions 1065 1081 1189 1219
EEG 363 352 413 409
EMG 221 220 329 311

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