HISTORY The
Early Years: 1885 to 1971 A
New Era: 1971 to present Another
beginning
Childrens Hospital of Los Angeles Rancho Los Amigos
National Rehabilitation Center USC
Neuromuscular Center
USC Neurologists, Inc.
Honors and Awards
The Early Years
In 1885, when the USC School of Medicine was founded,
the Los Angeles County Hospital had one trained neurologist
on staff. When the attending staff was officially organized
in 1917, separate sections for neurology and psychiatry
were included in the Department of Medicine. The first
neurology outpatient clinic was opened in 1923. Dr.
Cyril Courville, who was to have a great impact
on neurology at the Los Angeles County Hospital, was
one of the first appointed as an assistant resident
in 1929.
The first independent Department of Neurology at USC
was established in 1931 and headed by Dr. Samuel
Ingham. He was joined that year by his soon-to-be-renowned
associate, Dr. Johannes M. Nielsen.
The following year, Dr. Courville was appointed head
of neuropathology at the County Hospital and director
of the Cajal Laboratory of Neuropathology. His distinguished
neuropathologic studies lent special luster to the department.
These three men, Drs. Ingham, Nielsen, and Courville,
and the physicians they attracted to the neurology service
at the Los Angeles County Hospital made this an outstanding
service for the era.
Elinor Ives, M.D. arrived at the Los
Angeles County Hospital for her internship in 1933 and
in 1946 became the first woman on the neurology staff.
In 1953, she moved to the voluntary staff when she entered
private practice, but she continued her involvement
with the Department of Neurology until her death in
2001.
Following World War II, there was a great increase in
the number of inpatients treated at the Los Angeles
County Hospital. The peak census was in 1954-l955 when
the average number of patients treated on the service
reached 111. Dr. Nielsen became head of the Department
of Neurology and Psychiatry at USC when Dr. Ingham retired
during the l950s, and he remained on the attending staff
at the County Hospital until 196l. Dr. Karl
Von Hagen assumed the chairmanship of the Department
of Neurology at the USC School of Medicine in 1954.
A dual service by Loma Linda University and USC was
maintained until 1965 when Loma Linda moved its medical
school away from Los Angeles. From 1960-1969,
Dr. Howard Barrows served as head physician
of the neurology service for the hospital where there
were two residents and twelve attending physicians.
Dr. Barrows added much to the training of the residents,
particularly the teaching of a careful and detailed
neurologic examination. Among the staff he recruited
were Dr. Ruth McCormick (1959-1979)
and Dr. J. Eric Holmes, a master teacher
who was here until l982. Dr. Barrows himself (long at
the University of Southern Illinois) is recognized internationally
as an innovator in the field of medical education.
An additional increase in full-time staff improved the
neuromedicine service, and six residents comprised the
neurology residency in the 1960s. There were four wards
for neuromedical patients, each with a resident, two
interns, and usually a full-time physician in charge.
An intensive care ward for both neuromedical and neurosurgical
patients and a neuroradiology service were established
on the hospital's fifth floor.
Dr. Harry Fang joined the faculty in 1965 and
in 1973 was named director of the Division of Neurological
Sciences at Rancho Los Amigos Hospital, a position he
held until his retirement in 1991. Dr. Findlay
E. Russell, noted herpetologist, was recruited
in 1966. Still the only departmental alumnus to have
had a snake named in his honor, he conducted an active
program in pharmacology and toxicology until he moved
to Arizona in 1981. Also joining the neurology faculty
during this time was Dr. James Keane,
(internationally recognized for his observations in
neuro-ophthalmology) who is still active.
A New Era
Dr. Joseph P. Van Der Meulen was appointed
professor and chairman of the Department of Neurology
at the USC School of Medicine and chief physician in
charge of the hospital neuromedical service in 1971
when Dr. Von Hagen retired. Dr. Van Der Meulen worked
to modernize the Department of Neurology and the neuromedical
service with a greater academic orientation and an increased
emphasis on basic research. Recruited during his tenure
were Drs. Evelyn Lee Teng (clinical
psychologist); Peggy Gott (neurophysiologist);
and Theodore Munsat (known for his
work in neuromuscular disorders and now at Tufts). Others
who rotated through the department during this period
were Drs. Stephen Levy, Ronald
Andiman, Luis Chui, and Ronald
Saul.
Dr. Leslie Weiner was recruited to
establish the Grant Neuroscience Laboratories for basic
research In 1975. In 1979, when Dr. Van Der Meulen resigned
the chairmanship in order to serve as Vice President
for Health Affairs for the University on a full-time
basis, Dr. Weiner was appointed chairman of the Department
of Neurology.
Under Dr. Weiner's aegis, the major emphasis in the
department has continued to be education as well as
clinical and basic research. His initial actions were
to strengthen the programs in pediatric neurology, neuromuscular
disorders, neurovirology and neuroimmunology, behavioral
neurology, cerebrovascular disease, and epilepsy.
Dr. S. Robert Snodgrass became head
of the pediatric division of the Department of Neurology
in 1979 when Dr. Robert Sedgwick, who
had long maintained the pediatric neurology service
at the Children's Hospital of Los Angeles, became the
director of the EEG laboratory there. Dr. Snodgrass
was succeeded as division head briefly by Dr.
William Goldie, who served as acting head for
two year until Dr. O. Carter Snead, III
(I989 to 1995) arrived.
In 1997, Dr. Floyd H. Gilles became
head of this division, which includes also Drs.
Wendy Mitchell, Lan Chen, Verdette Brumm (clinical
psychologist), Linda Tseng-Ong. Shanti Thirmumalali,
here only briefly, has now moved to Paris.
Through recent years, several others have come and gone
at CHLA: Dr. Mark Citron added a basic
science component to the service, which was furthered
by Drs. Tallie Baram; Leslie
Brody (EEG), and Ken Huff (developmental
biology). Dr. Snodgrass return for a short period before
moving to UCLA, Dr. Tallie Baram (now at UC Irvine);
D. Rebecca Hanson (also now at UCLA), and Dr. Douglas
Hyder (oncology--now at Toronto's Hospital for Sick
Children).
Most of the present faculty have been recruited during
Dr. Weiner's tenure: Drs. W. King Engel and
Valerie Askanas came from the NIH and
George Washington University respectively to head the
department's division of neuromuscular disorders and
to establish the USC Neuromuscular Center at Good Samaritan
Hospital. Dr. Mark Fisher, now chair
of neurology at the University of California at Irvine,
was recruited to develop the stroke service. Dr.
Helena Chang Chui and Dr. Victor Henderson
(now directing a research program in Alzheimer
Disease at the University of Arkansas for Medical Sciences)
joined the faculty to add a behavioral neurology component.
Dr. Stephen Stohlman was added to strengthen
the virology/ immunology activities. Several basic scientists
joined the department: Drs. Peter Syapin
(now at Texas Tech in Lubbock); Lynn Perlmutter
(a neurobiologist who left for industry); Connie
Bergmann (neurovirology); Wendy Gilmore
(neuroendocrinology and neuroimmunology), Roel
van der Veen (neuroimmunology), and Brett
Lund (neuroimmunology), Michael Jakowec
(molecular biologist studying neuroplasticity)
and in 2001, Dr. Zhiquin Tan (molecular
neuroscientist now at UC Irvine)..
Specialty service recruits included Dr. Said
Beydoun (neuromuscular disorders), Drs.
Christopher DeGiorgio (now vice chair of neurology
at UCLA), David Ko, Christi
Heck, and Laura Kalayjian
(EEG and epilepsy). Dr. Shri Kant Mishra
was added as liaison with the Veterans Outpatient Clinics
in downtown Los Angeles and was joined later by Dr.
Carmie Puckett Robinson. Drs. Cheryl
Waters (now chief of clinical neurology at
Columbia University) and Mark Lew (now
division head), Mickie Welsh, R.N., DNSc (a
clinical nurse specialist concerned with Quality of
Life and Outcome for patients with chronic neurological
disorders) and Drs. Giselle Petzinger
and Allan Wu were recruited for movement
disorders. Dr. Gregory Chang was recruited
to head the service at LAC+USC Medical Center following
Dr. Henderson's resignation.
Others recruited include Drs. Scott Grafton
(PET and neuroimaging--now at Dartmouth), Steven
Schreiber (molecular neurobiology--now at UC
Irvine and chief of neurology at Long Beach Veterans
Hospital), Norman Kachuck (multiple
sclerosis therapy), Carol McCleary (neuropsychology),
Diana Van Lancker (neurolinguistics--now
chair of the Department of Speech-Language and Audiology
at New York University), Patricia Anderson (Alzheimer
disease--who moved to UCLA), Raji Grewal (neurogenetics--now
Neuroscience Institute of New Jersey), Margaret
Burnett (neurodegenerative disease), Bryan
Spann (movement disorders--now behavioral neurology),
and Robert Cowan (headache--who later
entered private practice in Sedona, Arizona).
A number of other people have come and gone through
the years: Dr. Karen Altman was part
of the epilepsy service in the early 1990s. In the late
1990s, Dr. Robert Young (world renowned
neurophysiologist—now retired) was here briefly
to help initiate a program for surgical intervention
for patients with Parkinson’s Disease.
Dr. Tiffany Chow added luster to Dr. Chui’s
neurobehavior division for a brief time before moving
on to the Rotman Research Insititue in Toronto.
Additional faculty added were Dr. Glenn M. Fischberg
and Dr. Gene Y. Sung to develop a stroke
program following Dr. Fisher's departure; Dr.
Marc C. Chamberlain, a neurooncologist, to
work with neurological surgery and medical oncology
to develop a neurooncology program; and Dr.
Soma Sahai-Srivstava, who assumed responsibility
for the General Neurology Outpatinet Clinic following
Dr. Gregory Chang’s resignation in 2002, to return
to Korea.
It is perhaps relevant to note that an academic department
such as this one necessarily not only educates medical
students, residents, and fellows as they rotate through
their training but also the faculty itself. In furthering
their careers and developing their evolving interests,
faculty also must sometimes move to another academic
environment. One measure of the success of the department
then becomes the places and positions presently occupied
by former members of the faculty.
Another
Beginning
Effective June 1, 2004, Helena Chang Chui, M.D., McCarron
Professor of Neurology and Professor of Neurology and
Gerontology, was named Chair of the department. She
had served as Interim Chair since August 2003, when
Dr. Weiner had ended his twenty-four year tenure in
the position to concentrate on patient care and research—both
basic and clinical.
Dr. Chui's leadership qualities were immediately evident.
Within the first few months as Interim Chair, she conducted
an internal review of the department--its strengths,
weakness, needs, and goal. As Chair, she has implemented
a new organizational structure aimed at achieving a
national rank among the top ten departments of neurology.
Under her direction and reflecting the stated mission
of the University of Southern California, the
Department of Neurology continues to strive for excellence.
Several sub-specialty clinics have been established
at the LAC+USC Medical Center. Long-standing is the
neuromuscular disorders clinic begun during Dr. Van
Der Meulen's tenure. Inaugurated in recent years have
been an Epilepsy Clinic, a Movement Disorders Clinic
devoted primarily to patients needing Botulinum toxin
injections for various dystonias, and a Multiple Sclerosis
Clinic providing comprehensive care. In addition, the
department is responsible for neurology for both the
OB/GYN clinic for high risk pregancy patients and the
AIDs Clinic.
Dr. DeGiorgio (at LAC+USC Medical Center and USC University
Hospital) and Dr. Snead (at Childrens Hospital of Los
Angeles) initiated the first surgical epilepsy programs
for adults and children, respectively, in the early
1990s. Following Dr. Snead's departure for Toronto,
Dr. DeGiorgio continued this program for adults with
intractable seizures. These multidisciplinary efforts
involving not only neurology and neurological surgery
but also neuropsychology, neurophysiology, and speech
have continued under the direction of Drs. Christi Heck
and Laura Kalayjian. Through their efforts in collaboration
with Dr. Michael Appuzzo (Neurological
Surgery), a new, multicenter clinical trial of Gamma
knife radiosurgery for temporal lobe epilepsy has been
initiated at USC.
Early in his tenure here, Dr. DeGiorgio achieved accreditation
for the Electrophysiology Laboratories at both LAC+USC
Medical Center and the USC University Hospital. In addition,
in 2001, the department began providing intraoperatie
monitoring for neurological surgery and orthopedics
at the Medical Center.
At both LAC+USC Medical Center and through the faculty’s
private practice, USC Neurologists, Inc., as well as
at Childrens Hospital of Los Angeles since the early
1990s, several dozen clinical trials in epilepsy, movement
disorders (including Parkinson’s Disease and dystonias),
cerebrovascular disease (stroke), multiple sclerosis,
Alzheimer’s Disease, and peripheral neuropathies
have been undertaken.
Childrens
Hospital of Los Angeles
Since 1979, the pediatric division of the department
has evolved under its succeeding directors—Drs.
Snodgrass, William Goldie, O. Carter Snead, III, and
Floyd Gilles. It provides a superb training program
and an excellent clinical service. Openings for incoming
fellows for the child neurology residency program, directed
by Dr. Wendy Mitchell, are filled several
years in advance. Despite limited staff, a heavy service
is maintained. Completion of an outstanding research
facility and initiation of a new program in developmental
neurobiology will enable the division to accelerate
significantly its basic science activities.
Rancho Los
Amigos National Rehabilitation Center
As director of the rehabilitation activities of the
department, Dr. Chui has developed at Rancho Los Amigos
Medical Center, (now Rancho Los Amigos National Rehabilitation
Center [RLANRC]), a facility long affiliated with the
university, a research oriented service with a major
focus on neurobehavior and cognitive neuroscience. In
addition, she established a multidisciplinary program
for the diagnosis and treatment of patients with Alzheimer
disease, which includes a daycare center. Recruited
for this service were Dr. Chris Zarow,
a molecular neurobiologist working to differentiate
Alzheimer’s Disease from vascular dementia, and
several neurologists: Drs. Ginte Jasculitis
and David Saperia (both now exclusively with
RLANRC), Jeffrey Victoroff, Lily
Atalla, and Arousiak Varpetian (who
besides joining Dr. Chui's team assumed responsibility
for neurology at the LAC+USC Medical Center AIDS Clinic).
USC Neuromuscular
Center
The USC Neuromuscular Center located at Good Samaritan
Hospital in Downtown Los Angles is directed jointly
by Drs. W. King Engel and Valerie Askanas. The two have
pioneered the use of laboratory research in the diagnosis
and treatment of motor neuron disorders, particularly
amyotrophic lateral sclerosis (ALS). This division includes
basic science laboratories and clinical facilities that
attract patients from around the world. Dr. Askanas
is a recipient of a coveted ten-year research award
from the NIH to further her work in inclusion-body myopathy.
The Center affords young basic scientists and clinicial
fellows opportunities for advanced training in the mysteries
of various neuromuscular disorders. Both Drs. Engel
and Askanas have received world wide recognition for
their work in this field.
USC
Neurologists, Inc.
In 1981 following guidelines developed by the School
of Medicine, the department established the faculty
practice through which its clinicians see private patients.
Through the years, USC Neurologists, Inc. has become
a busy, tertiary neurology practice comprising sub-specialty
clinics in Alzheimer Disease, Parkinson's Disease and
other movement disorders, epilepsy, multiple sclerosis
and other autoimmune diseases, neuropathies, and ALS
as well as general neurology.
Honors
and Awards
In 1987. Dr. Weiner was given the Richard Angus Grant,
Sr. Chair in Neurology. the first endowed chair in neurology
at USC. Funds for this as well as the earlier establishment
of the Grant Neurosciences Laboratories were given by
the Dan Murphy Foundation. In addition to this award,
the department has been the recipient of the following
endowments:
- the Appleman Research Fund--Parkinson's
Disease
- the Mary J. & Thomas C. Bowles Center for
Alzheimer Disease
- the G. Donald & Marian Montgomery
Endowment Fund
- the Rita H. Small Endowment for Alzheimer
- the Audette Garnier Epilepsy Research Fund
- the Jerry Price Seizure Clinic Fund (for children)
- the Childrens Hospital Los Angeles Affiliates and Associates Chair
in Neurology.
In 1997, the department received a generous gift from
Betty and Raymond McCarron to endow a professorship in
neurology and to create a clinical research and education
program related to Alzheimer disease and similar illnesses.
Dr. Helena Chang Chui was named McCarron Professor of
Neurology. She and Drs Bryan Kemp and
Laura Mosqueda (Rancho Los Amigos) were
named directors for the McCarron Center which is working
to improve the early diagnosis of dementing illnesses
and the collaboration among the various professionals
involved as well as to develop better measures for treatment
outcomes and techniques to assist caregivers.
A similar gift received in 1999 established the Kenneth
and Bette Volk Endowed Professorship in Neurology. Dr.
Victor Henderson was appointed to this professorship,
but no successor has yet been named. The Joseph P. Van
Der Meulen, M.D. Chair in Neurology for research in Parkinson's
Disease was funded by the Robert J. and Claire L. Pasarow
Foundation in 2000. The James and Dorothy Williams Endowed
Chair in Neurology was established to support the clinical,
research, and educational aims of the Stroke Program at
the Keck School of Medicine at USC. Also endowed was the
Leslie P. Weiner, M.D. Chair, bringing the number of endowed
chairs in the Department of Neurology to six.
The department has been fortunate to achieve research
funding from a number of agencies including the National
Institute on Aging, the National Institute for Neurological
Diseases and Stroke, the National Institute of Allergies
and Infectious Diseases, the National Science Foundation,
the Dan Murphy Foundation, The National Multiple Sclerosis
Society, the Muscular Dystrophy Association, Alzheimer’s
Disease and Related Disorders Association, Los Amigos
Research and Education Institute, the Joseph Drown Foundation,
the National Parkinson Foundation, the Epilepsy Foundation
of America, the John Douglas French Foundation, the Kenneth
Norris Foundation, the Gogian Family Foundation, the American
Heart Association, the Nancy Davis Foundation, the QueensCare
Foundation, and the Good Hope Foundation.
An annual report issued by the department summarizes faculty
activities, lists research funds received, and publications.
Members of the faculty fulfill the department's educational
mission for both the medical school and the broader community.
The clinical faculty provide the best and latest in tertiary
patient care. All of the faculty participate not only
in intra and interdisciplinary projects within the university
but also with colleagues everywhere. They lecture widely,
contribute editorial services to respected peer review
journals, conduct productive and innovative research into
myriad areas of neuroscience, and serve on professional
research review committees covering a broad spectrum of
fields related to neurology.
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