Neurology Division
Overview
The neurology division at King Abdulaziz Medical City (KAMC) provides comprehensive services in neurology and engages in both undergraduate and postgraduate teaching/training and research.
There are currently 8 qualified consultants and 1 associate consultant. 7 of which are consultant neurologists with different subspecialties (clinical neurophysiology, epilepsy, neuromuscular diseases, movement disorders, sleep and stroke disorders) and 1 is a consultant neurophysiologist. Six of the consultants are affiliated with King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS). The junior staff consists of 2 assistant consultants and one Saudi Board certified neurologist. The Neurology Residency Training Program (NRTP) currently consists of 9 neurology residents (3 at (R1) level, 2 (R2), 2 (R3) and 2 (R4) residents). Starting 2013-2014 academic year, the NRTP has been approved and accredited to recruit 4 new residents each year. In addition, there are specialist nurses in epilepsy and stroke along with well trained coordinators in epilepsy and clinical research.
The group provides comprehensive in-patient neurology and stroke services, consultation services, epilepsy and intra-operative monitoring, Botox therapy as well as different neurophysiologic procedures such as electroencephalograms, evoked potentials, nerve conduction studies, repetitive nerve stimulation and electromyography studies.
There are in-patient neurological and stroke beds plus access beds, as appropriate, in other wards as well as the neuro-intensive care unit (NICU). Acute neurology patients are initially managed in collaboration with the Emergency Department team until patients are admitted, subsequently, care services are mainly provided by the neurology teams. Easy access to state of the art interventional neuroradiology and neurosurgical services are available 24/7. Advanced radiology services as well as both in-patient and out-patient rehabilitation services are easily available at all times.
There were over 1600 patients (including elective/non-elective) in-patient and day cases seen during 2012. The current staff run busy, 21 per week, to cover general and specialized neurology outpatient clinics throughout the week at the Ambulatory Care Center and Medical Protocol Department Clinics with more than 10,000 patients seen during the year 2012. Specialized clinics include neuromuscular diseases, epilepsy, movement disorders, multiple sclerosis and stroke clinics.
The Neurology Research Team (NRT) is heavily involved in several research projects funded locally by King Abdullah International Medical Research Center (KAIMRC) and by King Abdulaziz City for Science and Technology (KACST) nationally. The NRT has collaborated with both national and international researchers and succeeded in several publications in respected international journals in addition to regular participations in international scientific meetings through verbal presentations or posters.
Introduction
Neurology Division in King Abdulaziz Medical City (KAMC), as a part of the Department of Medicine, functions in strong collaboration with other departments including Neurosurgery. Our scope of services includes 6 main disciplines: General Neurology, Stroke Management, Epilepsy, Movement Disorders, Multiple Sclerosis and Neuromuscular diseases with state of the art Neurophysiology Laboratory and services.
Services
The general Adult Neurology unit provides optimum patient care services to those who suffer from brain, spinal cord, peripheral nerves, and muscles diseases.
Consultants offer comprehensive clinical diagnostic evaluation and management of cerebrovascular diseases, epilepsy, headaches, CNS infections, neuro-behavioral, cognitive disorders, neuromuscular disorders, neuro-genetics, multiple sclerosis, movement disorders and common sleep disorders.
The Stroke unit at King Abdul Aziz Medical City, NGHA primarily aims to provide state of art care to stroke patients. The stroke unit is located in ward 23 of the hospital and currently admitting patients with both ischemic and hemorrhagic strokes. Patients with acute stroke are initially evaluated by the neurology team in the emergency department, and depending on their clinical profile, they will either be admitted directly to the Stroke Unit or will be closely observed in the Intensive Care Unit before being transferred to the Stroke Unit. The stroke team in collaboration with the interventional neuroradiology team provides state of art acute ischemic stroke care including intravenous and intra-arterial thrombolysis for eligible patients. The divisions of interventional radiology and neurosurgery are working in close cooperation with the stroke team. Once the patient is admitted to the Stroke Unit, a comprehensive multi-disciplinary care is provided, and it includes clinical, nursing, rehabilitative and social care services. Upon discharge however, patients will receive additional ongoing follow-ups in the Stroke clinic as out-patients.
There are dedicated physiotherapists, occupational therapists, speech and language pathologists and dysphagia specialists covering the Stroke Unit, as well as a devoted stroke team coordinator, social worker, health educator, discharge planner, and quality monitor. Furthermore, the stroke unit is expected to have a stroke registry in the near future to serve as a central system to collect, compile, and analyze stroke data. In conclusion, the Stroke Program in King Abdulaziz Medical City - Riyadh aims to develop a Stroke Unit to be one of the leading stroke centers in the world.
Neurophysiology is primarily an investigative specialty that uses specialized machines to record the brain, spinal cord, spinal roots, peripheral nerves, and muscles functions to help in diagnosing certain disorders of the nervous system.
Commonly used procedures include: Electroencephalography (EEG), Electromyography (EMG), Nerve conduction study (NCS) and Evoked potentials (EPs).
Intraoperative neurophysiological monitoring has been utilized in attempts to minimize neurological morbidity and reduce the risk of operative manipulations. The goal of such monitoring is to identify changes in the brain, spinal cord, and peripheral nerves functions prior to irreversible damage. It is also effective in localizing anatomical structures including peripheral nerves and sensorimotor cortex, which helps in guiding the surgeons during dissection procedures. Surgeries performed using this technique include scoliosis surgery, carotid endartrectomy, and resective brain surgeries.
Epilepsy is a chronic neurological disorder characterized by recurrent unprovoked epileptic seizures. This disease is common in the kingdom of Saudi Arabia as it is worldwide.
In-patient Epilepsy Monitoring Unit (EMU) in conjunction with two weekly epilepsy clinics have been created to enhance the diagnoses, classification and treatment of such patients. in some cases, candidate patients are referred for an epilepsy surgical procedure aiming to locate the part of the brain from which the seizures originate in an effort to offer a cure for their disease.
In collaboration with neurosurgery, pediatric neurology, neuroimaging and neuropsychology, this comprehensive multidisciplinary program is being directed by two well qualified epileptologists. Dr. Hasan Ayafi, a neurologist and an epileptologist, received his neurology training in Edmenton, Canada, and then he moved to Montreal Neurology Institute (MNI) to do his epilepsy fellowship under the supervision of Dr. Frederick Anderman as well as Dr. Ashraf Harthi, another neurologist and an epileptologist, who received his neurology and epilepsy training in London, Ontario - Canada.
On top of routine epilepsy procedures, other complex procedures are performed such as the invasive intracranial recording (cortical stimulation and mapping) as well as WADA testing. The aim of the epilepsy program is to be a center of excellence for epilepsy in the Kingdom of Saudi Arabia and the region.
The Division of Neurology at King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS)/King Abdulaziz Medical City (KAMC) offers a residency training program in Adult Neurology that is accredited by the Saudi Commission for Health Specialties (SCHS).
We at KAMC & KSAU-HS are fortunate to have excellent facilities for evaluating and treating people with neurological diseases. Our large population and the capacity of our institution ensure our professional staff and trainees the most expansive clinical exposure possible. The NRTP is able to utilize these resources to the fullest, providing an excellent foundation upon which to build careers in clinical and academic neurology medicine.
This vigorous and exciting training program is committed to providing the very best clinical training in preparation for a fulfilling career in Adult neurology. The width and depth of the training opportunities in general neurology specialty and the various subspecialties as well as clinical and basic research of neurology is our ultimate goal. We consider our training mission to be the development of the future leaders of adult neurology in the kingdom of Saudi Arabia and the whole region. Since it began in 2003, our adult neurology training program has undergone continuous and significant improvement. Our residents are chosen not only on the basis of their academic credentials but also on their personal and human qualities. We strongly believe that unselfish, good communication skills, collaboration, professionalism, dedication and collegial physicians, who work well together, are so essential to a fulfilling training experience for all residents.
The KAMC-National Guard Neurology Residency Training Program is an accredited (Saudi Commission for health specialties) four-year training program. We accept four residents each year. Graduates are eligible to take the certifying examinations offered by the Saudi Commission for Health Specialties Board of Neurology.
Current Staff
Dr. Suleiman Kojan, Head & Consultant (Clinical Neurophysiology)
Dr. Hasan Ayafi, Consultant (Epilepsy)
Dr. Mohammed Jumah, Consultant (Neuromuscular Disorders)
Dr. Ali Khathaami, Consultant (Cerebrovascular Diseases)
Dr. Abdullah Bin Saeed, Consultant (Movement disorders)
Dr. Ashraf Al Harthi, Consultant (Epilepsy)
Dr. Ismail Khatri, Consultant (Cerebrovascular Disease)
Dr. Faisal Jahangiri, Consultant (Intraoperative Neurophysiological Monitoring)
Dr. Ali Anazi, Associate Consultant
Dr. Sarah Bloushi, Assistant Consultant
Dr. Deema Al Rasheed, Board Certified Neurologist
Bed Capacity
There are in-patient neurological and stroke beds plus access beds, as appropriate, in other wards as well as the neuro-intensive care unit (NICU). The average daily number of patients is about 12-15 patients on each neurology and stroke services and about 10-15 new daily neurology consults. A two bed, newly upgraded, epilepsy monitoring unit is running at it maximum capacity.
During the year 2012, there were more than 60 patients admitted to the epilepsy monitoring program, at least 100 intraoperative monitoring procedures and more than 3500 electro diagnostic procedures were performed.
