Six decades of Neurology at NIMHANS: A historical perspective
Correspondence Address: Source of Support: None, Conflict of Interest: None DOI: 10.4103/0028-3886.227272
Source of Support: None, Conflict of Interest: None
The Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka has a long tradition of excellence in education, teaching, research, and patient care. Its exceptional alumni, as well as current and past faculty members, have made considerable contributions to the development of neurological services throughout the world. The six decades of its existence have seen a momentous growth in clinical, investigative, and community Neurology. As a result of the immense scientific individual as well as collaborative contributions of the faculty members in various departments, the Institute has had the honour of attaining the status of an autonomous 'Institute of National Importance' under the Ministry of Health, Government of India, through a novel concept of collaboration and partnership of central and state governments. This article traces the dedicated pursuit of members of the Department of Neurology, NIMHANS, in managing neurologic diseases through compassionate patient-centred care, transformative research and education.
Keywords: Department of Neurology, education, evolution, history, National Institute of Mental Health and Neurosciences, research, training
In the depths of the heavens, the moon sails shedding splendour that is a benediction. Below, on the troubled waters of life, moves the mind of man, swan-like. Nearby is the heart-lotus passion-laden and just blossoming. Hidden in the womb of waters lies peace, born of harmony, to be realised by one who has subdued passion.
“If I have seen further, it is by standing on the shoulders of giants” - Isaac Newton
The history of the department is not only to express our debt to our predecessors but is very important in understanding the progress that is taking place in the institute. The “art of healing” began in 1955 with the establishment of the Department of Neurology by an expert from World Health Organisation (WHO). Following is a brief history of how one of the most dynamic centres of Neurology has evolved over time. We hereby give a glimpse into the History of the Department of Neurology of NIMHANS:
62 Years of Caring, Teaching, and Innovations.
The Department of Neurology has a strong mission and a rich history at the National Institute of Mental Health and Neurosciences (NIMHANS). Neurology department has a long tradition of excellence in education, teaching, research, and above all, patient care. Over the years, numerous faculty members, students, as well as support and service staff from all over the country have been associated with the department and have cherished their fond memories of this sprawling university, nestled in the heart of Bangalore, the capital city of Karnataka. The Department has an exceptional list of alumni, as well as current and past faculty members who have made considerable contributions to the development of neurological services throughout the world. The department is committed to be the centre of excellence and innovation, dedicated to the pursuit of managing neurologic diseases through compassionate patient-centred care, transformative research and education of the future pioneers in Neurology.
In 1838, a dedicated ward for insane patients was set up in the Cantonment Hospital, in the city of Mysore, by Dr. Charles Irwing Smith. However, with the need for a separate facility for treating the mentally ill, a Lunatic asylumwas established in 1850 at the pettah (city) area, by the British. This was located in a building on the Avenue Road, which today houses the head office of the State Bank of Mysore. In 1881, the reign and administration of Mysore city was transferred from the British to the Wodeyar kings and many hospitals were built during their rule. In 1880-81, Surgeon Major J. Houston, who also was Superintendent of the Lunatic asylum, drew up a memorandum for all the medical facilities under the Wodeyar reign. He proposed a larger mental hospital in Bangalore in view of the increased population of Bangalore. The late 19th century marked the beginning of improvement in the status of asylums and the standard of care provided by them, by the introduction of scientific approaches to treat mental illnesses. In 1920, Dr. Francis Xavier Noronha became the first qualified Indian psychiatrist to head the Lunatic asylum. He proposed replacing the word 'Lunatic Asylum' by the term 'Mental Hospital' to remove the stigma attached with psychiatric disorders. Finally in 1926, the asylum was renamed as the 'Mysore Government Mental Hospital'. Maharaja HH Krishnaraja Wodeyar, Dewan Sir Mirza Ismail and Dr. Francis Noronha were instrumental in relocating the mental hospital to its present premises in Bengaluru in 1937. The plan of the building was based on the blueprint of the Bethlehem hospital at Lambeth, London, which was designed by the architect-cum-botanist Mr. Gustav Hermann Krumbiegel. The new building was named as 'All India Institute of Mental Health (AIIMH)'. The AIIMH included not only the hospital building but also the expansive lawns and gardens, as envisaged by Dr. Noronha together with Sir Mirza Ismail. In 2013, this beautiful greenery throughout NIMHANS, which many have fond memories of, was renamed as the “Noronha gardens”, in honour of Dr. Francis Noronha. The first Director of AIIMH was Dr. MV Govindaswamy, who along with Dr. William Mayer Gross (who was a World Health Organisation [WHO] consultant for teaching and training facilities), were instrumental in starting the postgraduate training programme. Under the recommendation of Dr. Gross, Dr. Julius Hoenig, an expert in electrophysiology and electroencephalography (EEG) from the Institute of Psychiatry, London, was appointed in AIIMH. He started teaching programmes and organized lectures in anatomy, clinical neurology and electrophysiology. Finally in 1957, Dr. DM Leiberman, who had worked with Dr. Hoenig in the Department of Neurophysiology at London, came to AIIMH on a WHO project and was appointed as the Professor of Neurology.
The Department of Neurology began in this Institute in 1955 with the establishment of the electroencephalography (EEG) services by Dr. J Hoenig. Interestingly, the start of electrophysiology services preceded the initiation of clinical Neurology services by nearly two years. The early years of the development of neurological services were due to the combined efforts of the WHO experts, Dr. DM Lieberman (1957-59) and Dr. EA Zysno (1957-59), as well as those of Dr. KS Mani, who was the first staff member in the Neurology department appointed by the institute [Figure 1]. Dr. KS Mani started the Department of Clinical Neurology with the aid of the WHO experts in 1957.
In 1958, the Departments of Neurology and Neurosurgery were located in one of the pavilions of the hospital which presently houses the Psychiatry wards. A separate Neurocentre building was sanctioned in 1964 by the then Hon'ble Chief Minister of Mysore, Sri S Nijalingappa, who was convinced of the need for dedicated neurological services after seeing a documentary by Dr. RM Varma on treating Parkinsonism by chemothalamotomy. There was a 9-year delay from the inception to completion of the Neurocentre because of the India-Pakistan war. Finally in 1973, the Neurocentre building was completed by Sri Hanumantha Rao, the chief architect of Karnataka and was inaugurated by His Excellency, the President of India, Shri VV Giri on 30th December, 1973.
On 27th December 1974, there was an amalgamation of the erstwhile mental hospital with AIIMH to form the National Institute of Mental Health and Neurosciences (NIMHANS), a multidisciplinary institute. This was essential to avert the several administrative issues of the state government-run hospital and the central government-run training and research institute. The institute was inaugurated on 14th February 1975 by Dr. Karan Singh, the then Hon'ble Union Minister for Health and Family Planning. The Institute attained the status of an autonomous institute under the Ministry of Health, Government of India, through a novel concept of collaboration and partnership of central and state governments. This amalgamation helped in fusion of services, teaching and research in the field of mental health and neurosciences. Advanced programs have been developed in the areas of biological, behavioural and basic sciences in relation to the brain-mind-behaviour axis. The vision of the founders was that the mission of the institute would be to serve as a nucleus for nurturing excellence in every aspect of health care.
The combined involvement of the Government of India, Government of Karnataka and Governing Body of the institute has given administrative and academic freedom of the highest quality for the growth and development of the institute. Over the next 2 decades, the enormous and steady growth of the Institute led to the 'Deemed University' status being conferred upon it by the Central government in 1994. Finally, in 2012, NIMHANS was declared as an 'Institute of National Importance'.
Over the next few years, the faculty developed clinical services of a high order. The teaching programs were targeted towards postgraduate students and the department took active part in imparting comprehensive Neurology training. A major step was the introduction of doctorate of medicine (DM) degree course in Neurology in 1971. The first batch of qualified Neurology students emerged from this institute in 1974, which coincided with the establishment of National Institute of Mental Health and Neurosciences (NIMHANS) in 1974, giving a major impetus to the development of Neurology. The next few decades have seen a momentous growth in clinical, investigative, and community Neurology. The faculty strength has shown a steady growth since its inception until the year 2004-2006 [Figure 2] and [Figure 3]. During this period, many faculty members have left the institute in search of greener pastures. Eventually, with the revised pay commission being set up by the government as well as the security of the job, and the enhancement of research and academic facilities at NIMHANS, a number of neurologists, especially those who had studied for their DM degree at NIMHANS, have been inclined to continue their work at this institute, and the faculty strength has gradually increased to its present strength of 19 members [Figure 4]. After the retirement of Dr. KS Mani in 1978, the first neurologist of the department, Dr. M Gourie-Devi took over the responsibility of the department as its Head of the Department for two decades; this was followed by many other members. Initially, the postgraduate courses and teaching were conducted under the aegis of the Bangalore University; the department became autonomous once NIMHANS became a deemed university in 1994. The next major development of NIMHANS was during the directorship of Dr. P Satishchandra when NIMHANS was conferred the status of “Institute of National Importance” in 2012 by an act of the Indian parliament, which was finally gazetted on 29th November 2013. [Figure 5] depicts the expansion of the Neurological services over 6 decades.
Dr. KS Mani (1957-78)
Dr. K. S. Mani [Figure 1] graduated in Medicine (MBBS) in 1952 and received his postgraduate degree in General Medicine in 1956 from Madras Medical College. Impressed by his sincerity and dedication during his 3-month tenure as a house-surgeon, Dr. B. Ramamurthi attempted to persuade him to specialize in Neurosurgery. However, determined in pursuing his career in Neurology and with the backing of Dr. Ramamurthi, in 1957, Dr. Mani moved to Bangalore to start the Department of Neurology at the All India Institute of Mental Health (AIIMH). Three years later, he visited the United Kingdom under the Colombo plan and had additional training in Neurology and Pathology at the National Hospital for Nervous Diseases at Maiden Vale and Queen Square in London (1960–1962). After his return to Bangalore in 1962, he along with two other stalwarts, Dr. RM Varma and Dr. GNN Reddy, known as the 'Trimurti', laid down the groundwork for the future NIMHANS, which was formally sanctified in 1974. He became the Professor and Head of the Neurology Department in 1969 and held the post until his voluntary retirement in 1978. He also served as in-charge Director of NIMHANS from 14-7-1977 to 16-4-1978.
Dr. Mani was instrumental in starting the systematic recording of clinical data in the Neurology Department. He worked extensively in the field of epilepsy and was the first to describe 'hot water epilepsy', a reflex epilepsy seen almost exclusively in the Karnataka state and South India. He also played a major role in the description of 'tropical spastic paraplegia' (TSP), which was initially named as 'South Indian paraplegia', and for establishment of the experimental model of neurolathyrism in monkeys. He was part of the multi-centric hospital-based study on the epidemiology of epilepsy funded by Public Law (PL)-480 (the United States [US] Agricultural Trade Development and Assistance Act, an action which simultaneously created the Office of Food for Peace) in India. He was one of the founders of the epilepsy movement in India. Dr. Mani started the Indian Epilepsy Association (IEA) in 1970 to give impetus to the social aspects of epilepsy and was the founder member of the Bangalore chapter and the Central IEA in 1970. He was the President of the Neurological Society of India (NSI) in 1972. After his retirement from NIMHANS, along with managing the Bangalore chapter of IEA and the Karuna trust, a non-governmental organisation, he undertook the 'Yelandur project', which was a community-based epilepsy survey project in the rural areas near Mysore, which have been highly successful in establishing the epidemiological study of epilepsy and its management in rural India. He was recognised for his contributions to the field of epilepsy in India by being conferred the 'Social accomplishment award', and the 'Ambassador for Epilepsy' award by the ILAE. He also received the 'Life Time Achievement Award' by ILAE just before his death. He is popularly called the 'Father of Indian Epilepsy'. He died in 2001, ending a very illustrious career in Neurology.
Over the next 60 years, many neurologists joined the Neurology department and contributed significantly to the phenomenal growth of our department. Today, some of our teachers/colleagues are no more with us and some have resigned or retired [Figure 2] and [Figure 3]. Currently (as of 1st November, 2017), the Department has 19 permanent faculty members and 2 ad hoc faculty members in Neurology [Table 1] and [Figure 4]. With the determination and dedication of both the past and present faculty members, the department has gained national and international recognition.
(a) Faculty members who are no more (we recollect their contribution to the growth and development of this department at NIMHANS)
Dr. KS Mani, Dr. VS Achar, Dr. H Sathyanarayana Swamy, Dr. Anisya Vasanth.
(b) Faculty members who have retired/resigned from the institute
Dr. M Gourie-Devi, Dr. D Nagaraja, Dr. Suresh Rao Aroor, Dr. TG Suresh, Dr. GR Arunodaya, Dr. E Ratnavalli, Dr. Uday Muthane, Dr. Joy Vijayan, Dr. Samhita Panda, Dr. Atulabh Vajpayee, Dr. P Satishchandra and Dr. AB Taly.
(c) Current Faculty members in the Department:
Dr. M Veerendrakumar, Dr. SR Chandra, Dr. A Nalini, Dr. Pramod Kumar Pal, Dr. Sanjib Sinha, Dr. Suvarna Alladi, Dr. PS Bindu, Dr. PS Mathuranath, Dr. Girish B Kulkarni, Dr. Ravi Yadav, Dr. M Netravathi, Dr. N Madhu, Dr. R Subasree, Dr. CM Ravindranadh, Dr. M Pooja, Dr. Nitish Kamble, Dr. PR Srijitesh, Dr. K Raghavendra, Dr. N Saraswati, Dr. AS Sreedhara, Dr Lulup Kumar Sahoo, and Dr Hansashree P.
Dr. M. Gourie-Devi (1977-2002)
In 1977, Dr. M Gourie-Devi joined the Institute with a keen desire to establish the diagnostic facilities for neuromuscular disorders. Dr. M-Gourie Devi obtained her MBBS from Andhra Medical College and King George Hospital, Vishakhapatnam, Andhra Pradesh in 1960, MD in Internal Medicine in 1964 and DM in Neurology in 1968 from the All India Institute of Medical Sciences (AIIMS), New Delhi. She then worked as an Assistant Professor of Neurology between 1968-70 at Osmania Medical College, Hyderabad, and later joined as a Consultant Neurologist at Safdarjung Hospital in New Delhi in 1970. She was awarded the Commonwealth Medical Fellowship in 1973 and got training in neuromuscular disorders and clinical neurophysiology at the Regional Neurological Centre, Newcastle- upon-Tyne and Royal Free Hospital, London. After returning to Safdarjung hospital in 1975, she continued her interest in neuromuscular disorders, especially leprous neuropathy. She established the neurological services at Safdarjung hospital and managed the neurological services single-handedly for 7 years up to 1977. With a keen desire to establish the neuromuscular services and to enhance the level of the existing neurological services, she joined NIMHANS as an Associate Professor of Neurology in 1977.
Contribution to the development of Neurology at NIMHANS
Soon after Dr. M. Gourie-Devi joined NIMHANS, the first electromyography (EMG) machine (DISA 1500) was sanctioned, which helped in establishing the Electroneuromyography (ENMG) laboratory for diagnostic and research purposes. She standardised the procedures of muscle and nerve biopsies, which were earlier being conducted by the neurosurgeons. Dr. DH Deshpande, Dr. Sarala Das and Dr. SK Shankar from the Department of Neuropathology supported the programme of muscle and nerve disorders. A bi-monthly slide session, an interdepartmental program of Neurology and Neuropathology, was started exclusively for the study of medical neuropathology with participation of faculty members and residents of both the departments and is very popular with the residents of Neurology till date. Dr. M Gourie-Devi started the monthly Neuromuscular Disorders Clinic in 1991 to provide comprehensive management of patients with muscular dystrophy and other neuromuscular disorders. The services included genetic counselling, physiotherapy and yoga.
NIMHANS became a deemed University in 1994 under the stewardship of Dr. SM Channabasavanna as the Director/Vice Chancellor and Dr. M Gourie-Devi was the Dean during that time. After serving as the Head of the Neurology Department from 1980 to 1997, she was appointed as the Director/Vice Chancellor of NIMHANS in 1997. During her period, specialized clinical facilities such as the Stroke unit, the Advanced Centre for Ayurveda in Mental Health and Neurosciences, and the Deaddiction Block were established. A novel course, Master of Philosophy (M Phil) in Neurosciences, was started for the first time in the country to foster basic and translational research with both biology and medical graduates being eligible to take up this program. She was also instrumental in conceptualizing the state-of-art Convention Centre of NIMHANS, which was inaugurated in September 2002 by Dr. AB Malaka Reddy, Hon'ble Minister of Medical Education, Government of Karnataka.
Dr. M Gourie-Devi made several contributions to neuro-epidemiology and public health. One of her landmark initiatives in public health was conducting the Bangalore Urban and Rural Neuroepidemiological (BURN) survey from 1993 to 1995, covering 1,02,000 people in and around Bangalore that attracted international and national attention. This included the first well-designed door-to-door neuroepidemiological survey in 1982 at Gouribidanur (Kolar district).
Her research areas included neuromuscular disorders, monomelic amyotrophy, motor neuron disease, leprosy, tuberculous spinal arachnoiditis and neuro-epidemiology. Apart from her research interests and contributions in the fields of neuromuscular disorders and epidemiology, Dr. Gourie-Devi also contributed significantly in the understanding of pure neuritic leprosy, intrathecal hyaluronidase injection in tuberculous arachnoiditis, monomelic amyotrophy and amyotrophic lateral sclerosis.
Achievements and Awards
She was the President of Neurological Society of India (1995), the first Vice-President of Indian Academy of Neurology [IAN] (1992-1993) and the Founding Editor of the journal, Annals of Indian Academy of Neurology. She served on the (i) Expert Advisory Panel on Neurosciences, World Health Organisation, (ii) World Federation of Neurology Research Committee on Neuroepidemiology, and (iii) Board on Global Health, Nervous System Disorders in Developing Countries, Institute of Medicine, National Academy of Sciences, USA. She was the (i) Honorary Advisor for Neurology Research, Indian Council of Medical Research and has also functioned as an Expert Member in the Department of Science and Technology (DST), Department of Biotechnology (DBT) and Defence Research and Development Organisation (DRDO). Dr. Gourie-Devi is a Fellow of National Academy of Medical Sciences (NAMS), Founder Fellow of Indian Academy of Neurology (IAN) and National Academy of Sciences (NAS). Dr. Gourie-Devi was also honoured with several national and international awards, which include (i) Basanti Devi Amir Chand Prize (1997) by the Indian Council of Medical Research, in recognition of her contribution to the field of Neurology and Neuroepidemiology, (ii) Om Prakash Bhasin Award (1998) by Shri Om Prakash Bhasin Foundation Trust for outstanding contributions in the field of Health and Medical Sciences, (iii) Dr. BC Roy Award in the highest category of Eminent Medical Person, Medical Council of India (2001), and (iv) the Doctor of Science [DSc] (Honoris Causa) degree by the NTR University of Health Sciences (2002) [Figure 6].
Dr. M. Gourie-Devi superannuated in November 2002 and joined as an Emeritus Professor of Neurology for life, at the Institute of Human Behaviour and Allied Sciences, New Delhi, and as Senior Consultant Neurologist and Chair, Department of Neurophysiology at Sir Ganga Ram Hospital, New Delhi. Post retirement, she is actively involved in addressing research issues in motor neuron disease and monomelic amyotrophy with particular emphasis on genetic profiling, and also continues to function as an Expert advisor to a number of international and national research organisations.
Dr. D. Nagaraja (1980-2012)
Dr. D. Nagaraja obtained his MBBS degree from the Bangalore Medical College in 1970. He then joined the post-graduation course in Psychiatry in the erstwhile AIIMH. During his post-graduation course in 1974, he met Dr. KS Mani, the Professor in Neurology, during an outbreak of the Handigodu disease in Sagar Taluk. He was highly influenced by Dr. KS Mani and joined the DM course in Neurology after completing DPM (Diploma in Psychological Medicine) in Psychiatry. In 1980, he joined as a Lecturer in Neurology and then steadily rose through the ranks to be appointed as Professor and Head of the Neurology Department (2000-2002), and finally served as the Director/Vice-Chancellor of NIMHANS from 2002 to January, 2010.
Contribution to development of Neurology at NIMHANS
He made systematic efforts to project neurosciences and behavioural sciences equally and was instrumental in obtaining several grants for the institute during the financial crisis. He organised a team which visited the tsunami affected regions of the country and carried out first aid and capacity development. He also undertook the National Mental Health Program (NMHP) to give impetus to psychosocial care during disasters. He introduced the MBBS-PhD programs with active collaboration of the Indian Council of Medical Research (ICMR).
Many sophisticated equipment and laboratories were added during his tenure as Director, which include: Gamma knife, deep brain stimulation facility, mass spectroscopic facility for metabolic disorders, Level 3 biosafety laboratory, sleep laboratory, and transcranial magnetic stimulation laboratory. He was instrumental in expanding the casualty and emergency services (a new building with over 100 beds, inclusive of a 25-bedded intensive care unit [ICU]). He established the first ever stroke unit in a government setup in 1996.
A new rehabilitation centre, a gait lab, a modern guest house, new open Psychiatry wards, an additional floor in the de-addiction facility, Neurosciences Faculty block and MV Govinda Swamy Academic block were his contributions. On the academic front, an increase in the number of seats in DM Neurology by 50%, starting a Nursing College (BSc degree) with a capacity of 75 students per year, and initiation of the MBBS-PhD programs in Clinical Neurosciences and in other disciplines were initiated during his tenure. In 1996, he organized the 4th Annual Conference of the Indian Academy of Neurology at NIMHANS, Bangalore.
He contributed significantly to teaching and research in the area of cerebrovascular diseases. He worked extensively on cerebral venous thrombosis (CVT) and introduced the use of low and medium dose heparin in treating CVT. His areas of research included studying the risk profile of stroke in the young, the role of anti-phospholipids antibodies and homocysteine as risk factors of stroke in the young, the epidemiology of stroke and the localisation of aphasias.
Achievements and awards
He was the recipient of many prestigious orations and awards, which include the Karnataka Rajyotsava award, Sir M Visveswaraiah award and BC Roy award of the Indian Medical Association (IMA).
Dr. Nagaraja was elected as the Honorary Secretary of the Indian Academy of Neurology for the period 1996–1999, as Vice president in 1999-2000, and as President in 2000-2001. He was the Editor of the Annals of Indian Academy of Neurology for 3 years. He is a founder fellow of the Indian Academy of Neurology, National Academy of Medical Sciences (FAMS), Indian College of Physicians and a World Health Organisation Fellow.
In 2012, Dr. Nagaraja was invited by the Government of Karnataka to head and develop the Dharwad Institute of Mental Health and Neurosciences as Director, and he developed that Institute with creation of 132 faculty and technical posts and the much needed infrastructure.
Dr. P. Satishchandra (1982-2017)
Dr. P Satishchandra joined NIMHANS as an honorary non-PG junior resident in Neurology in 1976 after completing MBBS degree from the Bangalore Medical College. He then joined the DM Neurology program in 1977, and after the successful completion of his course in 1981, joined as a faculty member in the department in April 1982. In 1986, he was selected for the International Neurosciences Fellowship under a World Health Organisation-International Neurosciences fellowship at the National Institutes of Health (NIH), Bethesda, USA and worked for 15 months as a visiting fellow and later as a visiting associate. After returning to NIMHANS, along with his mentor, Dr. M Gourie-Devi, he conducted the Bangalore urban rural neuroepidemiological (BURN) survey with a database of 102,000 population in and around Bangalore, which was the first large scale population based neuro-epidemiological survey in India. Later, he received the Raymond-way Lecturership at Queen Square, London for 6 months during 1999-2000.
Contribution to the development of Neurology at NIMHANS
He did extensive work on 'hot water epilepsy'. He developed an animal model for the disease, studied the functional and genetic aspects of the ailment, and changed the concepts in its management. Due to this extensive work, hot water epilepsy was included in the International Classification of Epilepsy by the ILAE. He started a multi- departmental Refractory Epilepsy Clinic in 1992 and a 'Comprehensive Epilepsy Programme' in NIMHANS. In addition to this, he made extensive contributions in understanding the clinical and genetic features of 'Lafora body disease' and neuronal ceroid lipofuschinosis (NCL) type of progressive myoclonic epilepsy (PME). He also worked on neuro-tuberculosis, neurological complications of retroviral disease and prion disease. Dr. Satishchandra served as the Head of the Neurology Department from 2002-2004, and in 2010 he was selected and nominated as the Director/Vice-Chancellor of NIMHANS.
He was successful in NIMHANS getting the status of “Institute of National Importance (INI)” in 2012 by an act of Parliament [Figure 7]. He started many new courses such as DM in Child and Adolescent Psychiatry, DM in Addiction Medicine, DM in Neuroanaesthesia, DM in Neuropathology, Dual-PhD in Neurosciences, and a number of Post-Doctoral fellowships (PDF) courses in Psychiatry and Neurology, many of them being introduced for the first time in the country. International scientific collaborations with several universities all round the world took place during this period. Many sophisticated equipment such as state-of-the-art digital subtraction angiography (DSA), magnetoencephalography (MEG), magnetic resonance imaging (MRI)-electroencephalography (EEG), positron emission tomography (PET)-magnetic resonance imaging (MRI) and intra-operative MRI were installed, which are being extensively used for patient care and research. He was also successful in getting 40 acres of land in Northern Bangalore from the Government of Karnataka with the plan of starting 'Northern Campus' of NIMHANS. During this period, there were several new initiatives undertaken, such as the establishment of a free legal cell, NIMHANS Centre for Well Being, Centre for Public Health (CPH) along with Public Health Observatory in Kolar, exclusive Women's Deaddiction wards and Adolescent Psychiatric wards. A Subspecialty Block in Neurosciences with 125 beds was initiated, which increased the total hospital bed strength from 854 to 1059. He started the 'Neurobiology Research Centre'(NBRC) in the previously built five-storied building and was instrumental in starting state-of-the-art 15 active research laboratories (in which more than 100 PhD students and a number of research scientists conduct their research work), three Centres of Excellence, Centres for Advanced Research (CAR) in Mental Health, Neuro Sciences and Innovation funded by the Indian Council of Medical Research (ICMR), Brain Museum, and Brain Bank. He was instrumental in upgrading and starting Psychiatric Rehabilitation Centre in Sakalwara. He also started the 'Heritage Museum', which houses historical treasures of the institute that include articles and displays from the inception of the Lunatic Asylum in the mid-1860s to the present. He was also successful in hospital digitalization in the form of establishment of the (electronic) E-hospital system and E-projects in NIMHANS. He was successful in getting a number of privately funded activities in the form of 'Infosys Foundation Dharmashala', R.N Murthy Foundation for Teaching and Training in Behavioural Sciences, TS Srinivasan (TSS-NIMHANS) Foundation in Neurosciences, and White Swan Foundation for creating awareness in mental health. During his period, 250 new posts were created which include more than 100 faculty positions. He also initiated a number of eco-friendly measures in the campus which included projects for water conservation, sewage treatment plants, rain water harvesting and a tree census. He organized a number of national and international conferences including the Annual Conference of the Indian Academy of Neurology in 2006.
He has extensively worked in the field of epilepsy especially hot water epilepsy, Lafora body disease, idiopathic generalised epilepsy (IGE), genetics of epilepsy, and the pre-surgical work up for epilepsy. In addition, he had research interests in the field neuro-human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), other neuro-infections including neuro-tuberculosis, neuro-leptospirosis and prion diseases, and has a number of research publications in these areas. He has also worked on various types of demyelinating disorders such as multiple sclerosis (MS) and neuromyelitis optica (NMO).
Achievements and awards
He has received several national and international awards which include the 'Sir CV Raman Young Scientist Award' (by the Government of Karnataka in 1997), “Amruth Mody Unichem prize” for Neurology (Epilepsy) in 1998 by the ICMR, Dr. BC Roy 'Doctor's Day Award' by the Indian Medical Association-Central Government Health Scheme (2003), Asia Oceanian Outstanding Achievement Award in Epilepsy from the Commission on Asia Oceanian Affairs, ILAE (2011), Sir J.C. Bose award for contribution in the field of Neurology (2012), Prof. Basanti Devi Amir Chand ICMR Award for Bio Medical Scientist (2013), Fellowship of the National Academy of Medical sciences (FAMS), Fellowship of the Royal college of Physicians [FRCP] (London) [in 2014], Sir M Vishweshwaraya Senior Scientist award for Contribution to Science and Technology in Karnataka (in 2016), 'International Ambassador for Epilepsy Award' by the ILAE and International Bureau for epilepsy (IBE) [in 2017] [Figure 8].
Dr. Satishchandra served as the Treasurer, President elect and President of the Indian Academy of Neurology, Vice-President, and later President of the Indian Epilepsy Society (IES), and the President of Bangalore Neurological Society, Founding member and President of Karnataka Neurological Society, Chair of the Regional Executive for South East Asia Epilepsy, and Member of the ILAE Genetic Commission for Epilepsy.
Dr. Satishchandra took voluntary retirement on 30th September, 2017 after serving the Department of Neurology for four decades.
Dr. H Satyanarayana Swamy (1974-2001)
Dr. HS. Swamy (more popularly known as “HSS”) was the second postgraduate student to have had training in Neurology at NIMHANS. After successful completion of DM training in Neurology, he joined as a faculty member at NIMHANS in the year 1974. He served as the Head of the Department from 1997-2000 and continued to serve the institute till his superannuation in May 2001. His main interest was Clinical Neurology and he spent hours in teaching students bedside clinical examination. He was very compassionate towards the patients and spent most of his time for the welfare of patients. He had significant contributions in the field of epilepsy, Wilson's disease, anti-rabies vaccine related neurological complications, and periodic paralysis. Following a brief medical illness, Dr. HS Swamy, passed away on 17th September 2010 at his residence in Bangalore.
Dr. AB Taly (1985-2017)
Dr. AB Taly completed DM Neurology at NIMHANS in 1983 and had worked as a faculty member for one year at the Sree Chitra Tirunal Institute of Medical Sciences, Trivandrum before joining NIMHANS as a faculty member in 1985. He obtained fellowship in Neurological Rehabilitation and Restorative Neurology at the University of California, Los Angeles (UCLA) in 1992, and was a Visiting Clinician at the Mayo Clinic, Rochester, USA, during 1999. His main areas of interests were in neurological rehabilitation, neuromuscular disorders, clinical electrophysiology, Wilson's disease, sleep disorders and mitochondrial disorders and has several publications to his credit in these areas. The duo of Dr AB Taly and Dr. Sanjib Sinha reinforced the clinical services and initiated clinical research in Wilson's disease through the speciality clinic that was established by Late Dr. HS Swamy in the 1970s.
Dr. AB Taly also strengthened the rehabilitation services for persons with disabilities due to neurological disorders at NIMHANS, which eventually led to the establishment of an independent full-fledged Department of Neurological Rehabilitation. He was instrumental in conceptualising and setting-up the 'Neuromuscular laboratory' in 2012 along with Dr. Gayathri N, Professor of Neuropathology, for state-of-the art research in inherited and acquired neuromuscular disorders. He is the recipient of the 'Fellowship of Academy of Medical Sciences' (FAMS) and 'Fellowship of the Indian Academy of Neurology' (FIAN) awards. Dr AB Taly served as the Head of the Department of Neurology from 2004 to 2007 and from 2009 to 2011 and as In-charge Head of the Neuro-Rehabilitation Services and Department from 2009 to 2015. He superannuated recently on 31st October, 2017 after serving NIMHANS for 32 years.
Dr. M Veerendrakumar (1989 till date)
Dr. Veerendrakumar completed DM Neurology at NIMHANS in 1986 and worked for a couple of years at the Sree Chitra Tirunal Institute of Medical Sciences, Trivandrum (SCTIMST), as a faculty member before joining NIMHANS as a faculty member in 1989. He served as the Head of Neurology Department from April 2007 to March 2009. His areas of specialisation include Clinical Neurology, neurocysticercosis, clinical electrophysiology, especially advanced EMG techniques and single fibre electromyography (SFEMG), and stroke. He was instrumental in starting advanced electrophysiology services at NIMHANS. He has conducted a number of national and international electrophysiology conferences including the recently concluded 6th Asian-Oceanian Congress of Clinical Neurophysiology (AOCCN) conference in November 2017.
Dr. SR Chandra (2009 till date)
Dr. SR Chandra obtained DM Neurology from Madurai Medical College in 1986 and was the Head of Neurology of Government Medical College, Trivandrum from 2001 to 2009. She joined NIMHANS in 2009 as the Professor of Neurology, and later served as the Head of the Department from April 2011 to March 2013. In 1976, she received the President's Medal for being nominated the 'Best Lady Medical Student of India' from the Countess of Duffrein's fund. She was the recipient of 'Best Doctor Award' of the Indian Medical Association (IMA), Alappuzha in 1999. Her clinical and research interests include cognitive neurology and geriatric care. Recognizing her contributions to the field of Neurology, she was awarded Fellowship of the Indian Academy of Neurology in 2017.
Dr. A Nalini (1999 till date)
Dr. A Nalini obtained DM from NIMHANS in 1994, following which she joined as a faculty in 1999. She served as the Head of the Department from April 2013 to March 2016. She is actively involved in the care of acquired and inherited neuromuscular disorders at the multidisciplinary Neuromuscular Disorders Clinic since 2002 after the retirement of Professor M. Gourie-Devi. She is the recipient of Sir C.V. Raman State Award for Young Medical Scientists for the year 2008. Her areas of interest and expertise are in the field of neuromuscular disorders including motor neuron disease, cervical flexion induced myelopathy (Hirayama disease) and neurocysticercosis. She has established the motor neuron disease registry at NIMHANS. During her period as Head of Neurology, she expanded electrophysiology laboratory services and started the neurophthalmology unit and the ultrasound laboratory for muscle and nerve disorders. Recognising her contributions in the field of Neurology, she was awarded Fellowship of the Indian Academy of Neurology in the year 2016 [Figure 9].
Dr. Pramod Kumar Pal (2000 till date)
Dr. Pramod Kumar Pal completed MD (General Medicine) from PGIMER, Chandigarh in 1989, and DM degree from NIMHANS in 1993. He worked initially as a faculty member in the Department of Neurology at Sri Venkateswara Institute of Medical Sciences (SVIMS) Tirupati from 1994-1997. After completing his clinical fellowship in movement disorders at Vancouver, Canada (1997-1999), he joined NIMHANS as an Assistant Professor in 2000. Later, he obtained expertise in human motor physiology during his clinical fellowship in human motor physiology and transcranial magnetic stimulation (TMS) from Toronto, Canada (during the years 2002-03). His areas of interest and expertise are in movement disorders, ataxia, human motor physiology and transcranial magnetic stimulation, structural and functional imaging in movement disorders and genetics of neurodegenerative disorders. Together with Dr. Uday Muthane, he has strengthened the movement disorders program at NIMHANS. He started the Parkinson's Disease and Movement Disorders Clinic in 2009 and also set up the Human Motor Physiology Laboratory. He was instrumental in starting the post-doctoral Fellowship Program in Movement Disorders at NIMHANS and is currently the program director of this program.
He became the Head of the Department in April 2016 and continues till date. The most important change in Neurology services implemented during this time is the creation of 6 clinical units in Neurology.
Dr. Pal has contributed significantly towards the Neurology services, and in particular, the treatment of movement disorders in India. He was the Treasurer of Indian Academy of Neurology from 2008-2014 and organized the 1st and 3rd Summer School of Neurology at NIMHANS. He was awarded the Fellowship of the Indian Academy of Neurology (FIAN) and is also the recipient of Janaki Memorial Oration award. He is the founder secretary of the Movement Disorders Society of India, the founder joint secretary of the Parkinson Research Alliance of India, the founder member of “The Neuromodulation Society”, member of the Governing Board of the Parkinson's Society of Karnataka, and has conducted several teaching courses on movement disorders. In the international arena, he was in the Educational Committees of the International Association of Parkinsonism and Related Disorders (IAPRD) and Movement Disorder Society- Asian Oceanian Section (MDS-AOS), and is the Secretary-Elect (2017-2019) and Secretary (2019-2021) of the International Parkinson and MDS-AOS.
(A) Previous faculty members
(1) Dr. VS Achar (1969-1979)
Dr. VS Achar joined the Department of Neurology as a part-time Reader in Neurology on 1st July 1967 while he was functioning as an Assistant Professor at the Bangalore Medical College. In 1973, he was promoted to the post of Associate Professor at the Bangalore Medical College. He initiated research in vascular and muscular disorders. He worked till 30th June 1974 and was later repatriated back to Bangalore Medical College.
(2) Dr. Gulshan K Ahuja (1969-1976)
Dr. GK Ahuja joined the institute as a Lecturer on 22 December 1969, when it was still the All India Institute of Mental Health., He worked in this capacity for 5 years till 5th November 1974. He was then appointed as an Assistant Professor on 6 November 1974 and served on this post until 8th March 1976. Then he moved to Delhi and joined as a faculty member at AIIMS, New Delhi. During his tenure, he was mostly assisting Dr. KS Mani in clinical work and in the field of epilepsy.
(3) Dr. HV Srinivas (1976-1982)
After obtaining MD in General Medicine from Ahmedabad in 1967, Dr. HV Srinivas joined as a faculty member in the Department of Medicine at MR Medical College, Gulbarga. His innate interests in Neurology led him to join the MD (Neurology) program in 1973 in Grant Medical College and JJ Hospitals Bombay, and he was fortunate to be trained by the giants in clinical Neurology, Dr. NH Wadia and Dr. BS Singhal. After completion of his MD Neurology, he went back to Gulbarga and continued as an Associate Professor in Medicine.
When NIMHANS was formed, Dr. KS Mani was looking for faculty members to join his department and he persuaded Dr. Srinivas to leave Gulbarga on the condition that he should accept a lower post, that of Lecturer in Neurology. Thus, Dr. Srinivas joined NIMHANS as a Lecturer in Neurology in 1976 and rapidly rose to the level of Assistant Professor and Associate Professor in Neurology.
He had an opportunity to work under Dr. Mani and learnt a lot regarding epilepsy, in particular, about its social aspects. He, however, left the Institute within a short time of his joining it. However Dr. Srinivas continued his association with Dr. Mani during his life time.
During his stay, Neurology Department at NIMHANS was quite small and the faculty members and the residents were like a family, known to each other personally. The sophisticated investigations had not yet invaded clinical medicine and so there was more time to talk with the patients and resident doctors. There were abundant clinical discussions and everyone looked forward to the Neuropathologists to give the final diagnosis, as computed tomographic (CT) scans or magnetic resonance (MR) scans were not even available at that time. Dr. Srinivas's main areas of interest were in epilepsy and dementia. Dr. Srinivas served as the Vice-President (2007-2008) and President (2008-9) of the Indian Academy of Neurology (IAN), and as Secretary and President of the Indian Epilepsy Assocation (IEA).
(4) Dr. BP Mruthyunjayanna (1974-84)
Dr. Mruthyunjayanna will be remembered in the history of Neurology at NIMHANS as the first student to join the DM course in 1971. After completing MD from the Bangalore Medical College in 1969, he was deputed by the Government of Karnataka to do DM in Neurology. Following completion of DM in 1974, he continued in NIMHANS as a Lecturer in Neurology. During his stay at NIMHANS, he worked primarily in the management of Japanese Encephalitis. In 1984, while working as an Assistant Professor in Neurology, he went back to Bangalore Medical College as the Professor and Head, Department of Neurology.
(5) Dr. Suresh Rao Aroor (1981-1991)
Dr. Aroor joined NIMHANS as a DM student after completing MD in Paediatrics from Kasturba Medical College, Manipal. He was appointed as an Assistant Professor to develop Paediatric Neurology at NIMHANS, while he was doing his Neurology training, as this sub-speciality was in its infancy in those days. He made significant contributions in establishing Paediatric Neurology during his decade-long stay at NIMHANS. His areas of interest were childhood epilepsy syndrome, inborn errors of metabolism and neuromuscular disorders in children. He resigned after 10 years to pursue Paediatric Neurology in his own private set up
(6) Dr. TG Suresh (1986-1989)
Dr. Suresh did his DM in Neurology at NIMHANS and was later appointed as an Assistant Professor of Neurology. He was an astute clinician and during his brief stay at NIMHANS, he strengthened the clinical bedside evaluation and teaching skills in Neurology and electrophysiology.
(7) Dr. Anisya Vasanth (1989-2003)
After completing DM in Neurology from NIMHANS in 1989, Dr Anisya Vasanth joined the Department of Neurology at her alma-mater as a faculty member. She worked at the University of California under the supervision of Dr. Alaric Arenander for acquiring technical skills in immunohistochemistry in 1991-92. She obtained a short term WHO fellowship in the Department of Neurology at the Mayo Clinic, Rochester, USA, under the expert guidance of Dr. Peter Dyck and Dr. Andrew Engel. Her areas of research interest included neuromuscular disorders, namely inherited and acquired neuropathies, muscular dystrophies, and myasthenia gravis. She was instrumental in developing the facility for acetylcholine receptor antibodies along with Dr. SA Patil, Professor of Neuromicrobiology. Under the guidance of Professor M Gourie-Devi, she initiated and actively contributed to the comprehensive clinical care and state-of-the-art research activities in the Neuromuscular Clinic at NIMHANS for nearly a decade.
Dr. Anisya Vasanth's untimely demise in 2003, when she was an Additional Professor, left a huge void in the Department of Neurology. She will always be remembered for her soft-spoken and pleasant personality, sincerity and dedication, and above all, her great compassion and kindness for the patients. To acknowledge her contributions to Neurology and mankind in general, NIMHANS has instituted the Dr. Anisya Vasanth Memorial Oration, a biennial institute program. In addition, the Dr. Anisya Vasanth Award is given each year to the final year DM student who is judged to have most of the qualities and virtues which epitomize Dr. Anisya Vasanth's personality.
(8) Dr. Arunodaya R Gujjar (1991-2005)
Dr. Arunodaya R Gujjar completed his training in DM Neurology at NIMHANS, and joined NIMHANS as an Assistant Professor. He, later, resigned as an Additional Professor in 2005. His initial interests were in clinical electrophysiology, mainly in the areas of sympathetic skin response and central conduction in myoclonic epilepsies. Following a United States Medical Licencing Examination Fellowship in Neurocritical Care, Dr. Arunodaya worked to develop the stroke unit as well as the neuro-intensive care unit. Decompressive craniectomy in large hemispheric strokes as well as cerebral venous thrombosis, intravenous thrombolysis for acute ischemic stroke, developing critical care for cortical venous thrombosis, and the utilization of transcranial Doppler ultrasound and transthoracic electrical bioimpedence for non-invasive hemodynamic monitoring, were some of the topics of his research interests leading to national and international publications and presentations.
(9) Dr. Ratnavalli Ellajosyula (1993-2004)
Dr. Ratnavalli Ellajosyula, after obtaining DM degree in Neurology from GB Pant Hospital, New Delhi, joined the Department of Neurology in April 1993, as an Assistant Professor. She was an excellent teacher and contributed to bedside teaching with emphasis on a good history-taking and examination. She was one of the earliest proponents of the Cognitive Neurology discipline and taught the residents bedside cognitive testing and approach to aphasia and dementia. She started the first Memory Clinic of the country in 1998 with focus on patients with dementia. She was the recipient of a Commonwealth Fellowship at the University of Cambridge (1999-2000) where she acquired more expertise in the area of Cognitive Neurology. Her contributions were in the areas of stroke and dementia. She was an Additional Professor when she left NIMHANS (June 2004) to pursue other interests.
(10) Dr. Uday Muthane (1994-2008)
After obtaining DM degree in Neurology from NIMHANS in 1990, Dr. Muthane worked as an Assistant Professor in Neurology at St. John's Medical College, Bangalore. In 1992, he joined as a Fellow in Movement Disorders at the Movement Disorders Division, Neurological Institute, Columbia Presbyterian Medical Center, Columbia University, New York, USA (with Prof. Stanley Fahn). After his return to India, he joined NIMHANS as an Assistant Professor in 1994 and with his expertise, played a leading role in the establishment of movement disorder services in the Department of Neurology. He was the recipient of several national and International research grants, the most noteworthy being “Is there a difference in the nigral numbers between different ethnicties?” from the Parkinson's Disease Foundation, New York USA, and “the clonidine-growth hormone stimulation test, and its comparison with standard autonomic testing, in the early diagnosis of Parkinson's disease and multiple system atrophy” from the Wellcome Trust, London, United Kingdom. The latter grant helped in establishing the “Autonomic Function Laboratory” of the Neurology Department. Dr. Muthane also worked extensively on the genetics of Parkinson's diease, Huntington's disease and other degenerative disorders. In 2007, he was awarded Sir C.V. Raman Award in Medical Sciences from the Karnataka State Council, for his outstanding achievements in science and technology [Figure 9].
Dr. Muthane's strong belief in the critical role of brain banking in Parkinson's disease research ensured that he enrolled some of the first patients for brain donation in the then newly commenced Human Brain Tissue Repository at NIMHANS. Much of the research endeavors in the country focused in Parkinson's disease have utilized human brain samples from the Brain Bank. His passion, commitment and proactive role in enrolling patients have contributed tremendously to foster research in the field of Parkinson's disease. In August 2008, while working in the capacity of an Additional Professor, he resigned from NIMHANS to join as Medical Director, Parkinson's and Aging Research Foundation, Bangalore, India.
(11) Dr. Samhita Panda (2004-2008)
After obtaining DM in Neurology from AIIMS in 2003, Dr. Panda worked as a post-doctoral fellow in epilepsy and epilepsy surgery at SCTIMST, Trivandrum (2003-2004) and also as a consultant neurologist in the same Institute for a brief period (Feb. 2004-Dec. 2004). Subsequently, she joined NIMHANS as an Assistant Professor in Neurology in December 2004. She continued her interest in the epilepsy surgery program at NIMHANS, including the presurgical workup of epilepsy and its intraoperative electrophysiological evaluation. In addition, along with Dr. AB Taly and Dr. Sanjib Sinha, she was actively involved in the initiation and establishment of the Sleep Laboratory of the Neurology Department. She was involved in the evaluation of sleep dysfunction in Parkinson's disease, Wilson's disease and Guillain Barre syndrome. She also contributed to the clinical services and research in the area of cerebrovascular diseases, including the evaluation and management of ischemic as well as hemorrhagic stroke and cerebral venous thrombosis. She was a co-investigator of the Bangalore Stroke Registry. She resigned in July, 2008 and joined Sir Ganga Ram Hospital in New Delhi.
(12) Dr. Joy Vijayan (2005-2008)
Dr. Vijayan completed DM Neurology at the Christian Medical College, Vellore in 2004 and worked as a Lecturer in the same college for an year. In 2005, he joined NIMHANS as an Assistant Professor in Neurology. He was interested in cognitive Neurology and had a speciality clinic once a week.
(13) Dr. Atulabh Vajpayee (2006-2007)
Dr. Vajpayee joined as an Assistant Professor in Neurology after obtaining DM in Neurology from Sanjay Gandhi Post Graduate Institute (SGPGI), Lucknow. During his brief tenure at NIMHANS, he primarily worked in the field of stroke.
(B) Current Faculty
(1) Dr. Sanjib Sinha
Dr. Sanjib Sinha joined NIMHANS in 2001 as an Assistant Professor. His key areas of research are in epilepsy, MEG, EEG, Sleep (polysomnography [PSG]) and Wilson's disease. The setting-up and smooth functioning of the MEG facility at NIMHANS, the first of its kind in India, is one of his significant achievements. Currently, he is leading the 'Comprehensive Epilepsy Program' at NIMHANS and has initiated the 'invasive EEG recording'. His original contributions are in signal processing of EEG and MEG records, status epilepticus, sleep in epilepsy and genetics of epilepsies. Recently, in a Department of Biotechnology (DBT) funded collaborative work, a gel-less portable EEG system with automated seizure detection has been manufactured for the first time in India.
(2) Dr. Suvarna Alladi
After completion of DM at NIMHANS in 1998, Dr. Alladi joined Nizam's Institute of Medical Sciences (NIMS) at Hyderabad. After working for 17 years and establishing the cognitive sub-speciality at NIMS, she joined NIMHANS as a Professor in 2015. In the last 2 years, her focused enthusiasm has significantly contributed to strengthen the cognitive subspeciality of the Neurology department.
(3) Dr. PS Bindu
Dr. Bindu obtained MD in Paediatrics from the Sree Avittom Thirunal. Hospital, Medical College Thiruvananthapuram, Kerala and DM (Neurology) from NIMHANS. She joined the Department of Neurology in 2006 as an Assistant Professor. During her 11 years of service, her work has been primarily focussed on developing Paediatric Neurology as a sub-specialty through active involvement in patient care, academics and research in the field. Her research works spans over a wide spectrum of paediatric neurological disorders including paediatric demyelinating disorders, paediatric epilepsies, paediatric neuropathies, diagnostic and management aspects of paediatric autoimmune encephalitis, as well as neurometabolic and neurogenetic disorders, especially leukoencephalopathies and mitochondrial disorders. She has been the key person in creating a platform for both diagnosis and research in the area of mitochondrial disorders, including the mitochondrial respiratory chain assays in the neuromuscular laboratory at the Neurobiology Research Centre, along with the research team led by Dr. AB Taly. She also explored the utility of MRI pattern recognition in the diagnosis of various neurometabolic and neurogenetic disorders. Along with scientists from Indian Institute of Science, she has been instrumental in studying and reporting the genetic variations in a large cohort of patients with PLA2G6 related disorders from India. Her recent work involves the diagnostic utility of the exome sequencing in various paediatric neurological disorders including early-onset epileptic encephalopathies, mitochondrial disorders, leukodystrophies and genetic leukoencephalopathies in children.
(4) Dr. Girish Kulkarni
Dr. Kulkarni's primary areas of interest are cerebrovascular disorders and headache. He is involved in planning and initiating services for acute ischemic stroke and in investigating the role of anticoagulation in cerebral venous thrombosis. He is also involved in studies on the mechanism of headache and has been involved in the first Cochrane study on headache in India.
(5) Dr. P.S Mathuranath
Dr. Mathuranath joined as an Additional Professor in Neurology at NIMHANS in 2012. Prior to that he was a faculty of Neurology at Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, where he had obtained his DM training. Dr. Mathuranath's primary area of interest is cognitive Neurology. After joining NIMHANS, he has initiated an integrated cognitive Neurology service that includes Neurology, Neuropsychology and Psychiatry departments, working together and jointly guiding research of students.
(6) Dr. Ravi Yadav
Dr. Ravi Yadav joined NIMHANS as an Assistant Professor in 2008, after completing DM from AIIMS, New Delhi. With his strong commitment to movement disorders, he soon joined the movement disorders program established by Dr. Pramod Kumar Pal and has helped in starting the Parkinson's Disease and Movement Disorders Clinic in 2009. Over the next 8 years, the Movement Disorders Program has received national and international credibility. Apart from movement disorders, his current area of work extends to sleep disorders. He is also the Founder Treasurer of the Movement Disorders Society of India and is the co-editor of the book 'Bickerstaff's Neurological Examination in Clinical Practice' (7th Edition).
(7) Dr. M. Netravathi
After obtaining DM in Neurology from NIMHANS, Dr. Netravathi worked as a Consultant Neurologist at Narayana Hrudayalaya Institute of Neurosciences for 2 years, and later joined NIMHANS as an Assistant Professor in Neurology in 2011. Her current areas of interest and work are in demyelinating disorders such as multiple sclerosis and neuromyelitis optica. She has also worked and has research publications in secondary movement disorders, paediatric movement disorders, tuberculous meningitis and human immunodeficiency virus - related neuroinfections.
(8) Dr. N. Madhu
Dr. Madhu Nagappa joined her alma mater as a post-DM senior resident soon after completing her DM in Neurology and was subsequently promoted as an Assistant Professor in May 2011. Her areas of interest include peripheral neuropathy, myasthenia gravis, mitochondrial and other neurogenetic disorders, and clinical electrophysiology, among others.
(9) Dr. R. Subasree
Dr. Subasree's research interests and on-going work are in clinical and electrophysiological aspects of Guillain Barre syndrome, management of immune mediated neuropathies and myasthenia gravis, and cognitive neurology (mild cognitive impairment, degenerative dementias, and dementias related to cysticercosis and small vessel disease).
Further, since 2015, six more faculty members have joined the Neurology Department as Assistant Professors, with varying areas of interest [Table 1]: Dr. CM Ravindranadh, Dr. M Pooja, Dr. Nitish Kamble, Dr. K Raghavendra, Dr. PR Srijithesh and Dr. N. Saraswati. They are actively involved in various teaching and research programs of the Neurology Department apart from contributing to the clinical services.
The clinical services of Neurology initially started with a single unit and then expanded to three clinical units. Each unit has 3-4 faculty members, junior and senior residents pursuing DM course, residents posted from the Neurosurgery and Psychiatry departments, students/residents posted for Neurology training from medical colleges, and sometimes students/consultants from India and abroad keen on doing observership in Neurology. With the increasing number of faculty members and DM residents and the number of patients attending the daily outpatient services, the clinical units have increased to six from 1st November, 2017, with the doctors attending both the daily regular, as well as review, outpatient services.
The Neurology department caters to outpatient, inpatient and emergency care for patients from all over India, and even from abroad. Continuous efforts have been made to provide better services by improving the infrastructure with the establishment of new buildings as well as bringing about an increase in the facilities.
(A) Outpatient Services
The Neurology Department runs outpatient services from Monday to Saturday [Figure 10]. The outpatient service is provided at three levels:
(B) Emergency and Casualty services
The Neurology department of NIMHANS is one of the few centres which provide dedicated casualty and emergency services round the clock. Each clinical unit of Neurology is on call duty on a rotational basis [Figure 11]. The junior and senior residents are posted in the casualty.
In the mid-70s, the casualty services started in a small room with 4-5 beds, which was later enlarged and finally moved to a separate building near the Neurocentre with approximately 120 beds. The current casualty building, which offers services both for Neurology and Neurosurgery, has a triage area (40 beds being common for Neurology and Neurosurgery), priority ward (23 beds being common for Neurology and Neurosurgery), Short Stay Ward (20 beds for Neurology) and ICU (6 beds for Neurology), with approximately 60 beds being available at any given time for Neurology.
On an average, 60-70 patients with a variety of acute neurological problems are seen per day, leading to approximately 19,000 patients/year receiving acute care. The common emergencies include stroke, neuroinfections, seizures, status epilepticus, myelopathies and Guillain-Barre syndrome. The acute stroke intervention program is integrated with the Casualty services.
(C) In-patient services
(D) Laboratory facilities of the Neurology Department:
More than six decades ago, in 1955, the Department of Neurology started its activities by the establishment of EEG services by Dr. J Hoenig, even before the start of clinical services. Today, the department houses a state-of-the-art 'Clinical Neurophysiology Laboratory'. [Figure 17], [Figure 18], [Figure 19], [Figure 20] lists the various diagnostic facilities and laboratories that have developed at NIMHANS over time. [Table 2] lists the previous and current staff of the Clinical Neurophysiology Laboratory and the MEG Centre. Currently, there are six technicians: Mrs. Beulah Ebenezer (Head of the Electrophysiology section), Mr. CP Aiyanna, Mr. BC Nagaraju, Mr. TB Karthikeyan, Mr. G Perumal, and Mr. PM Mohammed Shareef and Staff nurse Mrs. K Murugeswari. The staff at the MEG Centre include Dr. N Mariyappa (senior scientific officer), Mr. G Prashanth (technician) and Ms. Kiran Jyoti (staff nurse) [Figure 21].
Briefly, the Neurology department has the following laboratory facilities which cater to daily diagnostic services and research [Figure 22]:
(E) Neurology diagnostic facilities in collaboration with other departments:
The Department of Neurology also closely collaborates with other departments for several diagnostic tests for routine patient care and also for research [Figure 23]:
Neurobiology Research Centre
This centre was established to promote interdisciplinary translational research at NIMHANS, to establish inter-institutional collaborative research with leading research institutes within and outside the country, and also to facilitate advanced molecular diagnostic service for neurological disorders in 2011-12. The various facilities available are:
(F) Special Clinical Services
Apart from the routine clinical care for acute and chronic disorders in Neurology, the department also offers several state-of-the-art services in different sub-specialities of Neurology:
The second mandate of NIMHANS and the Neurology Department is the development of teaching, training and manpower in Neurology.
(A) DM Neurology program
DM (Doctorate in Medicine) in Neurology was started in 1970 for manpower development in clinical, investigative, academic and research aspects of Neurology. Initially, DM in Neurology was open to postgraduates in MD Medicine or Pediatrics. In 1976, MBBS students were also recruited for a five-year DM Neurology program (the only institute in the country to implement this concept at that time). The post MBBS course is of a 5-year duration and the post-MD course is of a 3-year duration. The annual intake was increased gradually from 2 in 1972 to 4 in 1977 when Dr. M Gourie-Devi joined the Institute. This has been steadily increasing, and in 2017, the total seats for DM Neurology has reached the figure of 14 (post-MBBS-4, post-MD-10).
The students are selected on the basis of an all India competitive online entrance examination (separate examinations for post-MBBS and post-MD courses) once every year in the month of March. The academic year starts on 1st July of the year. The candidates are provided training in Clinical Neurology as well as Emergency Neurology including stroke and electrophysiology, besides giving them exposure to other disciplines including Neuropathology, Neuroradiology, Neurosurgery, Psychiatry, Child Psychiatry and Neuropsychology. Currently, the post-MBBS students spend the initial 6 months in the Neurology department at NIMHANS, and then spend the next 18 months in the Bangalore Medical College for training in Internal Medicine and allied specialities. At the end of 2 years, they appear for the DM part-I examination (Medicine). The students join back the Neurology residency program in the third year along with the new batch of post-MD-DM students. The third year students are assigned a guide for one dissertation that they need to submit. They complete DM part-II (basic science) examination after another 18 months, and the final DM examination (part-III) at the end of 3 years. The training program is structured to enable the specialist not only to meet the present needs but also to achieve skills necessary to meet the future challenges in Neurology.
Over the last 47 years, a total number of 195 students from various parts of the country [Figure 24] and [Table 3] have completed the DM degree in Neurology. They are now employed in the public or private sectors in India, and abroad. It is a matter of great pride and satisfaction that some of them have distinguished themselves and are occupying coveted faculty positions and heading the Neurology departments in various hospitals and institutions in India and abroad.
(B) Post-Doctoral Fellowship (PDF) Program
With an increasing demand of subspecialisation in various disciplines of Neurology, Postdoctoral Fellowship Programs (PDF) in Movement Disorders and Epilepsy were started in 2012. This is a one-year course after specialization in Neurology (DM/DNB) and the candidates are selected annually on the basis of an entrance examination held in March every year. The course starts on 1st July of the year. Currently PDF courses are being offered in Movement Disorders, Epilepsy, Stroke, Neuromuscular, and Paediatric Neurology (one open category seat for each, and in addition, one sponsored seat each for Movement Disorders and Epilepsy). In addition to this, PDF in Neurorehabilitation and Neurocritical Care also exists at NIMHANS, for which post-DM/DNB Neurology students can also compete. Till date, 11 PDF students have completed training from NIMHANS [Table 4].
The Neurology Department also supports sponsored Fellows to conduct research under the guidance of faculty members in Neurology. Currently, Dr. T. Nivethida has joined as a Wellcome-DBT Intermediate Career Fellow in Movement Disorders.
(C) PhD program
The faculty memebrs of Neurology are also actively engaged in mentoring (either as the principal guide or co-guide) students of PhD in Clinical Neurosciences (a 5-year course sponsored by the Indian Council of Medical Research) and also PhD in Neurology at NIMHANS. They are also actively participating as a joint guide/co-guide for a number of other clinical and basic departments in the institute. An unique dual-PhD course also exists in Clinical Neurosciences in collaboration with University of Liverpool in UK, as well as the Maastricht University in the Netherlands from the year 2012-13.
[Table 5] lists the PhD scholars who have completed or pursuing PhD under the primary guidance of the faculty members of the Department of Neurology.
(D) Short-term training programs for Postgraduate students
From the time of inception, the Department of Neurology is offering short-term training in Neurology (usually 1-3 months) for postgraduates students of General Medicine, Paediatrics, Psychiatry, Neurosurgery and Neuroradiology. The Department also offers short-term training for students undergoing DM/DNB training in Neurology in other colleges. Specialists in these disciplines are endowed with knowledge, develop confidence in managing common neurological problems and thus are in a position to fulfil community needs for neurological services to some extent. In the year 2016, approximately 300 postgraduate students underwent short-term training in Neurology.
(E) Diploma in Clinical Neurophysiology and Technology (DCNT) Program
With the establishment of a number of Neurology units in various institutions and hospitals, diagnostic electrophysiology services have become an integral part of neurological services. There is an increasing demand for trained technicians in clinical neurophysiology. A comprehensive program including electronics, biomedical engineering, computers, theoretical and practical aspects on EEG, Video EEG, ENMG, evoked potentials and EMG, leading to a diploma course (DCNT), was initiated in the year 1994. Initially it was a one-year course; with the expanding electrophysiological services, the program was modified as a two-year course from the year 2012. The candidates for this course are being selected on the basis of an interview. Currently, six candidates are selected each year for this course.
(F) Observership Program
Apart from the above programs, the Department of Neurology also offers observership programs in Neurology or specialized areas of Neurology (for 3-6 months) for practising neurologists from India as well as abroad. The postgraduates in the fields of Medicine, Paediatrics, Psychiatry and Neurosurgery are given training in different sub-specialities of Neurology or in electrophysiology. Specialists in these disciplines are endowed with knowledge, develop confidence in managing common neurological problems, and thus, are in a position to fulfil community needs for neurological services to some extent.
(G) Visiting Professor Program
There is also a Visiting Professor Program for eminent neurologists from India and abroad to come and spend a few days in the Neurology department and share their expertise in clinical services, teaching and research.
The DM curriculum has a structured teaching program for the residents throughout the year.
This includes the following:
No organization can grow or sustain its achievements without a committed ministerial staff. In the last few decades, the Department of Neurology has been fortunate to have several such dedicated personnel, who have helped not only in maintaining the records of Neurology office and the official documents related to the faculty and residents but also in maintaining confidentiality. Mr. H Nagaraja served as a personal assistant to several Heads of Departments of Neurology from1980-2013. Mr. M.V. Srinivasan (popularly called MVS) served the department from 1981-2014, and was indispensable for the day-to-day secretarial work of all the faculty members. Other staff memebrs include Mr. Krishnappa (retired), Mr. CH Mruthunjaya, Mr. BR Karthik, Mr. Syed Sadaquath Hussaini, Miss. P Chitra, Mr. N Siddaraju and Mr. H Javaregowda.
Over the last 4 decades, the Department of Neurology has contributed significantly to improve the knowledge of physicians and neurologists in India and abroad through the organizing of a variety of scientific meets (regional, national and international and institute convocations) of high quality, either alone or in collaboration with other departments/organizations [Figure 25], [Figure 26], [Figure 27], [Figure 28], [Figure 29], [Figure 30], [Figure 31], [Figure 32], [Figure 33], [Figure 34], [Figure 35] and [Table 6]. Probably the first documented scientific meet was in 1975, when Dr. K.S. Mani organized the National Seminar on Epilepsy. Five years later, Dr. Gourie-Devi organized the conference, “Recent Advances in Leprosy Research” under the aegis of World Health Organisation (WHO) and the Directorate General of Health Services. Subsequently, several workshops and continuing medical education (CME) programs have been organized on neuroinfections, neuroepidemiology and motor neuron disease.
Dr. Gourie-Devi was the Organising Secretary of the 29th Annual Conference of Neurological Society of India in 1979 (a component of the joint conference held at NIMHANS December 7-10, 1979). In 1994, Dr. BS Das along with Dr. Gourie-Devi organized the 43rd Annual Conference of Neurological Society of India (NSI). Subsequently, the 4th Annual Conference of the Indian Academy of Neurology (IANCON) was organized by Dr. Nagaraja in 1996, and Dr. Satishchandra organized the 16th Annual Conference of Indian Academy of Neurology (IANCON) in 2006.
To commemorate 50 years of NIMHANS, the Departments of Neurology and Neurosurgery jointly organized the National Neuroscience Conference as a part of the Golden Jubilee celebrations in 2004. Dr. Veerendrakumar organized the International Clinical Neurophysiology Update Conference in 2007.
Teaching courses in Movement Disorders (TCMD) sponsored by the Educational Society of the World Federation of Neurology-Association of Parkinson's Disease and Related Disorders [WFN-APRD] (TCMD-2010 at NIMHANS and TCMD-2012 at Goa), Summer Schools of Neurology and Epilepsy of the Indian Academy of Neurology and Indian Epilepsy Society, Annual TS Srinivasan-NIMHANS Knowledge Conclaves from 2015 onwards, 2nd Annual Conference of the Movement Disorders Society of India (MDSICON) [held in January 2017] and 6th Asian-Oceanian Congress of Clinical Neurophysiology (AOCCN) [held in November 2017] are some of the other recent National and International Scientific meetings organized by the Department of Neurology at NIMHANS.
Since the inception of the Neurology Department and visits of Dr. Julius Hoenig and Dr. DM Leiberman six decades ago, several eminent scientists and neurologists (>125) have visited the Neurology Department [Figure 36], [Figure 37], [Figure 38], [Figure 39] and [Table 7] often during several scientific meets held at NIMHANS. Notable scientists include Dr. J A Simpson, Dr. Bala V Manyam, Dr. Shyamal Sen, Dr. Bindu T Desai, Sir John N Walton, Dr. WG Bradley, Dr. DC Gajdusek (Nobel Laureate), Dr. A Hirano, Dr. BS Schoenberg, Dr. Baldev Singh, Dr. Simon Shorvon, Dr. J Engel, Dr. Gustavo C Roman, Dr. Baxter, Dr. Fredrick Andermann, Dr. Ms. Andermann, Dr. Allen Hauser, Dr. WI McDonald, Dr. Janz, Dr. P Wolf, Dr. James F Toole, Dr. Robert D Daroff, Dr. Micheal J Aminoff, Dr. MR Trimble, Dr. T Subramaniayam, Dr. Michael N Dringer, Dr. David Chadwick, Dr. Christopher Mathias, Dr. J Andoni Urtizberea, Dr. Irene Litvan, Dr. Z. Wszolek, Dr. Alberto Albanese, Dr. Craig Anderson, Dr. Avindra Nath, Dr. Majaz Moonis, Dr. Pushpa Narayanaswami, Dr. K Ray Chaudhuri, Dr. Elena Moro, and Dr. TA Pedley.
Research and Publications
The third mandate of the Neurology Department is research in neurological sciences. The department conducts primarily clinical, applied and basic research through several intra-mural and extra-mural grants, grants from international agencies and the scientific dissertations of the DM and PhD students. The Neurology department is fortunate to have a strong collaboration with other clinical departments, behavioural sciences and basic sciences at NIMHANS and other Institutes within and outside Bangalore [Figure 23]. The important departments within the institute that have an ongoing collaborative research with the Department of Neurology include Neuroimaging, Clinical Psychology, Neurorehabilitation, Neuroepidemiology, Psychiatry, Neurochemistry, Genetics, Neuropathology, Neuromicrobiology, Neurovirology, Neurophysiology, Neurosurgery, etc.
The fields of research have been primarily dictated by the expertise of the past and present faculty members in the department and also is dependent on the need for research in a particular area. Many faculty members have undergone extensive training abroad and returned to NIMHANS with expertise and innovative ideas on the ways to start various sub-specialities. However, as with any other centres in India, the roadblocks for research include lack of funding, paucity of dedicated research personnel, the immense clinical load and the lack of time. However, in spite of the several impediments, the Neurology department is now recognized as one of the pioneering centres of clinical neuroscience research in India and abroad. While it is not feasible to discuss the details of research in the last 60 years, the growing number of peer reviewed articles published each year from the department [Figure 40] and [Figure 41] are a testimony to the intense dedication and commitment of faculty members and students towards research. In brief, the research have focussed on the following areas of Neurology:
The important contributions of the Neurology Department in understanding the pathophysiology of several neurological disorders or novel clinical descriptions include:
The faculty members of the Neurology Department are recipient of several prestigious national and international awards, which have been mentioned earlier in the article. The important awards include Ambassador for Epilepsy award and Life Time Achievement Award by ILAE (Dr. KS Mani), International Ambassador for Epilepsy Award by ILAE and IBE (Dr. P Satishchandra), Basanti Devi Amir Chand Prize by ICMR (Dr. M Gourie-Devi, Dr. P. Satishchandra), Asia Oceanian Outstanding Achievement Award in Epilepsy (Dr. P Satishchandra), Dr. BC Roy Award by Medical Council of India (Dr. M Gourie-Devi), Dr. BC Roy Award of Indian Medical Association [IMA] (Dr. D Nagaraja), Dr. BC Roy 'Doctor's Day Award' by IMA-CGHS (Dr. P Satishchandra), Karnataka Rajyotsava award (Dr. D Nagaraja, Dr. P Satishchandra), Janaki Memorial Oration award (Dr. Pramod Kumar Pal), Sir M Visveswaraiah award (Dr. D Nagaraja and Dr. P Satishchandra), Sir CV Raman Young Scientist Award (Dr. P Satishchandra, Dr. Uday Muthane, Dr. A Nalini), and Sir J.C. Bose award for contribution in the field of Neurology (Dr. P Satishchandra).
The Department of Neurology has been recognised as the best single super-speciality department in India in the years 2012 and 2014 [Figure 6], [Figure 8] and [Figure 9].
The Neurology of NIMHANS has contributed significantly to the growth and development of neurosciences in India over the past 6 decades. It has trained more than 190 neurologists from all over India, who are now well accomplished and settled in different parts of India and abroad. They have been instrumental in developing excellent Neurology services apart from the contributing to manpower development in Neurology and research.
The Department has excelled in clinical and basic science research in Neurology through various national and international collaborative projects and dissertation of students pursuing DM and PhD courses. The growing number of publications [Figure 40] and [Figure 41] in national and international journals is a testimony to the increasing contribution of the department in the field of research.
Apart from this, the faculty members of the Neurology department have been actively engaged in organizing national and international scientific meets and in improving and updating the knowledge of Neurology among the physicians and neurologists of India. Several faculty members have served as office bearers of the societies of Neurology and Neurosurgery. Apart from strengthening general Neurology services and societies, many faculty members of the Neurology Department have been founding office bearers of societies and of subsections of Neurology such as stroke, epilepsy, movement disorders, cognition, neuromuscular disorders, demyelinating disorders and tropical neurology.
Few noteworthy contributions are: (i) Dr. Mani started the Indian Epilepsy Association (IEA) in 1970, (ii) Dr. Mani and Dr. Gourie-Devi were Presidents of the Neurological Society of India (1972 and 1995 respectively), (iii) Dr. Gourie-Devi was the first Vice-President of IAN and the Founding Editor-in-Chief of Annals of Indian Academy of Neurology; (iv) Dr. D. Nagaraja was the Honorary Secretary (1996-1999), Vice-President (1999-2000) and President (2000-2001) of IAN and Editor-in-Chief of Annals of Indian Academy of Neurology, (iv) Dr. HV Srinivas was the Vice-President (2007-2008) and President (2008-9) of IAN; (v) Dr. P. Satishchandra served as the Treasurer (2002-2008), President-Elect (2010-2011) and President of IAN (2011-2012), and President of Indian Epilepsy Society (2013-2016), President of Karnataka Neurology Academy (2014); (vi) Dr. Pramod Kumar Pal served as the Treasurer of IAN (2008-2013) and Founding Secretary of the Movement Disorders Society of India (MDSI); (vii) Dr. Ravi Yadav served as the Founding Treasurer of MDSI; and, (viii) Dr. M. Netravathi served as the Founding member of MDSI.
Visions for the Future
NIMHANS, and in particular the Department of Neurology, has witnessed an extraordinary growth over the last six decades. The Neurology Department's motto of service, manpower development and research has brought in international recognition. The untiring dedication of all staff members, and in particular, the residents and faculty members, will bring in more laurels and soon it will serve as one of the nodal centres for neurosciences internationally.
In brief, the Department's priority would be to deliver comprehensive neurological care across the life span of an individual through innovations related to diagnostics and treatment protocols and by their seamless integration with preventive strategies applicable in the national context. One of the priorities would also be to generate new knowledge keeping in view the international scenario.
The steps to achieve the above mission would be through:
Departments of Health Education (Photography), Academic section, Personnel section, Publication section and Library for providing useful information, documents and photographs.
Source of information
While the authors have tried to verify all the information provided in this manuscript, they apologize for any inadvertent factual error.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8], [Figure 9], [Figure 10], [Figure 11], [Figure 12], [Figure 13], [Figure 14], [Figure 15], [Figure 16], [Figure 17], [Figure 18], [Figure 19], [Figure 20], [Figure 21], [Figure 22], [Figure 23], [Figure 24], [Figure 25], [Figure 26], [Figure 27], [Figure 28], [Figure 29], [Figure 30], [Figure 31], [Figure 32], [Figure 33], [Figure 34], [Figure 35], [Figure 36], [Figure 37], [Figure 38], [Figure 39], [Figure 40], [Figure 41]
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7]