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History

 

Regional Hospital Martin:
Department for Nervous and Mental Diseases

District Institute of National Health (OÚNZ) Martin:
Department of Neurology

Faculty of Medicine and Martin Faculty Hospital

Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, and Martin University Hospital:
Cinic of Neurology

 

Heads of the Department

  • Assoc. Prof. MUDr. Štefan Klima (1945 – 1950)

  • Assoc. Prof. MUDr. Karol Trávnik, CSc. (1950 – 1958)

  • Head Physician MUDr. Ladislav Bevilaqua (1959 – 1962)

  • Prof. MUDr. Marek Böhm (1962 – 1968)

  • Prof. MUDr. Václav Piťha, DrSc. (1968 – 1974)

  • Prof. MUDr. Karol Matulay (1974 – 1976)

  • Prof. MUDr. Michal Drobný, DrSc. (1976 – 2002)

  • Prof. MUDr. Egon Kurča, PhD. (2002 – present)

     

Author of the text: Prof. Drobný

The Clinic of Neurology in Martin has a 70-year tradition. In 1949, it was established as the first independent neurological department in Slovakia, with 60 beds, under the leadership of Assoc. Prof. MUDr. Zoltán Klima. In 1951, in cooperation with the Department of Radiodiagnostics, carotid artery angiography was introduced in Martin. The level of clinical neurology in Martin ranked among the highest in Slovakia, which led to the establishment of the Department of Neurology of the Slovak Institute for Postgraduate Education of Physicians in Martin, headed by Assoc. Prof. MUDr. Karol Trávnik, CSc., until its relocation to Trenčín and subsequently to Bratislava.

In 1955, routine cerebral angiography was supplemented with an EEG laboratory equipped with an 8-channel Keiser EEG device, and a chronaximeter was used for measuring rheobase and chronaxy. In 1958, rehabilitation and balneology were incorporated into the Department of Neurology. Due to the decline in the number of metaluetic diseases and the relatively low incidence of cerebrovascular strokes (CVA), the bed capacity of the department was reduced to 45 beds in 1959, during the reorganisation of Martin Hospital. At that time, the department was a regional referral centre for Central Slovakia and had strong personnel resources. The head of the department was Head Physician MUDr. Ladislav Bevilaqua. The medical staff included MUDr. Karol Zuska, CSc., MUDr. Dušan Droppa, MUDr. Eva Strelková, MUDr. Zuzana Mináriková, and MUDr. Michal Drobný. At that time, it was an exceptionally large team of neurologists, and its quality contributed to the establishment of the branch workplace of the Faculty of Medicine of Comenius University in Martin, which started in 1962. Practical teaching was provided by Assistant Professors MUDr. M. Drobný and MUDr. T. Krištofová. Lectures were originally given by Martin neurologist MUDr. Ferdinand Balek, and later by Assoc. Prof. MUDr. Marek Böhm. Practical teaching was further supported by MUDr. Ladislav Sobocký, CSc., MUDr. Jiří Jágr, MUDr. P. Varsik, and MUDr. Daniel Bartko, CSc. Another significant alumnus of Martin neurology is Assoc. Prof. MUDr. František Podivínsky, DrSc.

In 1965, the new head of the department, Prof. MUDr. Václav Piťha, DrSc., built an annex for outpatient and teaching facilities within the premises of the 8th hospital pavilion. The department was equipped with a 3-channel EMG device from Galileo, and later with an EMG device from DISA, enabling the examination of evoked potentials. The deputy head of the department was Head Physician Bevilaqua. This technology was used and developed by MUDr. Michal Drobný, CSc., and Ing. Jozef Fundárek in the so-called Novák House. At that time, a significant polygraphic laboratory was established in Martin, performing examinations of exteroceptive reflexes for clinical diagnostics and research. After the death of Prof. Piťha in 1974, the leadership of the Department of Neurology was assumed by Assoc. Prof. MUDr. Michal Drobný, CSc., who, after defending his habilitation thesis, was appointed head of the department. He introduced the practice of joint neurological-radiological ward rounds and daily seminars on the course of night duty, admitted patients, and the results of consultative examinations. This form of study and maintenance of professional standards became a key principle in the training of young neurologists.

In the 1970s and 1980s, the department was profiled as a centre for the diagnosis and treatment of acute conditions in neurology, as well as for research in cerebrovascular diseases. Therefore, in 1970, an Intensive Care Unit was established at the Department of Neurology, with four acute and six intermediate beds. In 1974, a paediatric neurology outpatient clinic was opened, headed by MUDr. Mária Sabová, and from 1982 by MUDr. Danica Vladárová. Towards the end of the 1980s, paediatric neurology was also practised by MUDr. Katarína Druneková, who provided paediatric neurological consultations at the hospital.

During Prof. Piťha’s leadership, the department was strengthened by MUDr. E. Kalašová, Assistant Professor MUDr. Oskar Záhorský, Assistant Professor MUDr. Anna Laciová, and MUDr. Eduard Gajdoš. Later, the staff was expanded by MUDr. Pavel Sýkora, MUDr. Miloš Mlynček, MUDr. Karol Točík, MUDr. Jozef Adamkov, MUDr. Božena Piťhová, MUDr. Eva Wolfová, MUDr. Viliam Krajňák, MUDr. Antónia Švaleková, MUDr. Mária Adamková, MUDr. Aksiňa Oríšková-Krajňáková, MUDr. Milan Luliak, MUDr. Mária Luliaková, MUDr. Soňa Ševčíková, MUDr. Mária Chmelíková, MUDr. Eleonóra Hrončeková, MUDr. Jana Froncová, and MUDr. Ľubica Kneslová.

In the 1970s and 1980s, the department possessed state-of-the-art equipment. Polygraphic reflex analyses, polyelectromyographic-kinesiological and basic EMG examinations, and evoked potential testing were performed. On the medium-sized computer SM 3/20, the first digitisation of EMG signals was carried out. Applied statistics and the first epidemiological studies of cerebrovascular diseases (CVA) were conducted in 1983–1986, again in 1988, and the last in 1996–1997. Since 1969, the department has been engaged in monitoring spongiform encephalopathies in clinical practice, from diagnosis to the clinical course leading to death. Prof. Drobný, in cooperation with MUDr. Eva Mitrová, DrSc., and Assoc. Prof. MUDr. Vlastimil Mayer, DrSc. (with the assistance of North American professor of Slovak origin D. C. Gajdusek), produced a globally unique monograph Slow Viral Neuroinfections (Mayer V., Drobný M., Mitrová E., 1983).

Under the leadership of Prof. Drobný, characteristic withdrawal reflex patterns were described, typical of cerebral lesions and of the reaction of an almost or completely isolated caudal spinal cord. Another original method introduced into experimental and clinical practice in the 1980s was the technique of eliciting stretch and shortening reflexes by passive sinusoidal movements of the forearm or lower leg. Clinically and electrophysiologically, groups of patients with multiple sclerosis were observed, treated alternatively with corticosteroids, acupuncture, and magnetotherapy. Assoc. Prof. Drobný defended his scientific degree of DrSc. (1984) by addressing this issue and was subsequently awarded the title of University Professor in Neurology (1985). During this period, MUDr. Jozef Adamkov defended his dissertation on parkinsonism induced by chronic manganese intoxication, earning the degree of CSc., and in 1989 he was appointed Associate Professor in Neurology. In 1990, MUDr. Božena Piťhová, CSc., also obtained her academic title of Associate Professor in Neurology.

The position of deputy head of the department, originally held by Head Physician Bevilaqua, was assumed in 1985 by Head Physician MUDr. Viliam Krajňák.

At the turn of the 1980s and 1990s, the Department of Neurology acquired top-level devices, including the Nicolet Pathfinder for all modalities of evoked potential studies and the Nicolet Viking II E electromyograph, including a Cadwell magnetic stimulator. This advanced technology was utilised by MUDr. Jozef Michalik and MUDr. Egon Kurča. In 1994, Head Physician MUDr. Jozef Michalik became deputy head of the department. In the second half of the 1990s, another talented physician, MUDr. Milan R. Voško, joined the department.

Prof. Drobný cooperated with Prof. MUDr. Daniel Bartko, DrSc., on the updated edition of the successful national textbook of neurology from 1985, resulting in the publication Bartko D., Drobný M.: Neurology (1990). Prof. Drobný, together with English lecturer Annamarie, also prepared the first and second editions of neurology teaching texts in English: Lectures of Neurology (1996) and Neurology Lectures (1997).

 

In 1989, Prof. Drobný became the first Dean of the Jessenius Faculty of Medicine in Martin to be democratically elected by the Academic Senate of the faculty, serving until 1991. Prof. Drobný was also chairman of the Joint Expert Committee for the scientific field of Neurology 51-12-9 at the Ministry of Education of the Slovak Republic and, in the 1990s, a member of the Accreditation Commission of the Government of the Slovak Republic. His work was recognised in 1998 when he was awarded the Ľudovít Štúr Order, 3rd Class, for outstanding contributions in science and research in Slovakia. For several decades, Prof. Drobný also carried out extensive expert and assessment activities.

Author of the text: Prof. Kurča

In 2000, MUDr. Egon Kurča, PhD., defended his habilitation thesis entitled Quantitative Electromyography and was awarded the academic title of Associate Professor. For one year, during the absence of Head Physician MUDr. Jozef Michalik (international fellowship), he served as Deputy Head of the Clinic. In 2002, Assoc. Prof. Kurča was appointed by the Dean of the Jessenius Faculty of Medicine, Comenius University, as Head of the Clinic of Neurology.

Between 2002 and 2019, the Clinic of Neurology acquired a fully digital paperless EEG system, including long-term video-EEG monitoring with two camera systems (one camera recording the patient’s face in detail and the other capturing the whole body in bed or sitting in a chair).

The system for evoked potential (EP) testing was supplied by Medtronic Keypoint in 2018. A top-class electromyographic (EMG) device from Medtronic Keypoint was installed in 2016, along with a new magnetic stimulator from Magventure MagPro (2018), enabling both low-frequency and high-frequency repetitive stimulations, including paired stimulations. It is equipped with a special patient chair with head fixation and a stimulation coil with a water-cooling system. The EMG device allows all types of quantitative EMG, as well as SFEMG, routinely used in clinical practice. The department also possesses a top-class Esaote ultrasound (US) system (2020), enabling both extracranial and intracranial vascular examinations at the patient’s bedside. The device also performs bubble-tests for detecting right-to-left cardiac shunts. An 18 MHz probe allows peripheral nerve imaging and use in musculoskeletal ultrasound. Under US guidance, procedures such as deep sacroiliac joint punctures are performed. The department is also equipped with a Rimed system (2014) for detecting intracranial vascular embolism.

In recent years, several long-term and distinguished members of staff have retired (MUDr. Ľubica Kneslová, PhDr. Daniela Šútorová, MUDr. Katarína Druneková, MUDr. Mária Adamková, MUDr. Milan Krátky, Assoc. Prof. MUDr. Božena Piťhová, CSc., secretary Ľubica Hořínková). MUDr. Mária Cuninková, who was also a specialist in paediatric neurology with expertise in EEG and epileptic seizures in both children and adults, also left the department. In 2016, the Paediatric Neurology Outpatient Clinic at the Clinic of Neurology was closed, and a new Paediatric Neurology Outpatient Clinic was established within the Clinic of Children and Adolescents, JFMED CU and Martin University Hospital.

In 2009, Prof. MUDr. Egon Kurča, PhD., was appointed Full Professor in Neurology at the historic Carolinum in Prague by President Václav Klaus. Since then, the scientific and research performance of the department has increased significantly.

At present, the department’s Deputy Head for Teaching Activities is Assoc. Prof. MUDr. Štefan Sivák, PhD., specialising in vestibular and non-vestibular dizziness, videonystagmography, functional MRI, MR spectroscopy, dementia, and mild traumatic brain injury. The Deputy Head for Clinical Activities, following the retirement of Head Physician MUDr. Jozef Michalik, PhD., is Assoc. Prof. MUDr. Vladimír Nosáľ, PhD., whose main expertise lies in cerebrovascular diseases of the brain and spinal cord. The Deputy Head for Science and Research is Assoc. Prof. MUDr. Ema Kantorová, PhD., a renowned expert on multiple sclerosis and related disorders.

Academic staff also include Assistant Professor MUDr. Monika Turčanová Koprušáková, PhD., and MUDr. Milan Grofik, PhD., on a part-time academic contract. Teaching activities are also supported by other physicians of the department, who are employees of the University Hospital: MUDr. Babeta Hofericová, MUDr. Jana Dluhá, PhD., MUDr. Klaudia Kalmárová, PhD., MUDr. Jana Olekšáková, PhD., and MUDr. Róbert Ružinák, PhD. Despite his age of 85, former head of the department Prof. MUDr. Michal Drobný, DrSc., still actively participates in teaching and clinical practice. The Clinic currently has two full-time PhD students (MUDr. Lucia Babálová, MUDr. Pavol Skáčik).

The Clinic of Neurology is a supra-regional centre for the diagnosis and treatment of acute cerebrovascular stroke, with the possibility of thrombolytic therapy and, in cooperation with the Department of Radiology, mechanical thrombectomy and many other highly specialised endovascular procedures. In 2021, a new Cerebrovascular Intensive Care Unit with 10 beds was opened in Pavilion No. 6, meeting the highest global standards in space and equipment. The head physician of the new unit is Assoc. Prof. Nosáľ.

The Clinic of Neurology has been awarded the status of a Centre for Extrapyramidal Disorders. In addition to Prof. Kurča and Dr. Grofik, the team includes MUDr. Patrik Kašovič, MUDr. Jana Olekšáková, PhD., and MUDr. Ján Necpál (external collaborator from the Department of Neurology in Zvolen). In this centre, in addition to advanced diagnostics, above-standard therapeutic procedures are carried out. These include the use of subcutaneous apomorphine pumps and jejunal Duodopa pumps for Parkinson’s disease, in which Mgr. Vlasta Grofiková plays an important supporting role.

The department also applies the method of deep brain stimulation for Parkinson’s disease, various tremors, and dystonic disorders. This is carried out in cooperation with the Department of Neurosurgery, Slovak Medical University and FNsP F. D. Roosevelt in Banská Bystrica, where the implantation of intracerebral electrodes and extracerebral neurostimulators takes place (thanks to Prof. MUDr. Miroslav Galanda, CSc., MUDr. Tomáš Galanda, PhD., and Head of the Department MUDr. Ján Šulaj, PhD.). The application of botulinum toxin in dystonic patients is managed by Dr. Turčanová Koprušáková.

The clinic also includes a Centre for the Diagnosis and Treatment of Multiple Sclerosis, where patients receive the latest biological therapies (e.g. natalizumab, alemtuzumab, and ocrelizumab). Staff of the centre include Prof. Kurča, Head Physician Michalik, Assoc. Prof. Kantorová, MUDr. Natália Jankovičová, and MUDr. Marek Tarčák. A Psychology Outpatient Clinic is also part of the department, led by PhDr. Ján Grossmann, who is engaged in diagnostics, therapy, and research of patients with multiple sclerosis.

The clinic also has the status of a Centre for Degenerative and Autoimmune Neuromuscular Diseases. The medical staff of this centre include Prof. Kurča, Dr. Turčanová-Koprušáková, Dr. Grofik, and a new team member, MUDr. Kristián Šveda. Standard treatment includes the administration of polyclonal human intravenous immunoglobulin in indicated cases.

Within Slovakia, the clinic is an important centre for the diagnosis and treatment of epileptic and non-epileptic seizure disorders, with the possibility of referring patients for epilepsy surgery in cooperation with an international centre at St. Anne’s Faculty Hospital in Brno. The lead physician in this field is Dr. Hofericová, with team member MUDr. Jana Zeleňáková.

Laboratories form an important part of the clinic. The EEG laboratory is led by Dr. Hofericová with technicians Mirka Thomková and Ľubica Hrončová. The EP laboratory is headed by Dr. Jankovičová, the EMG laboratory by Dr. Turčanová-Koprušáková, and the US laboratory by Assoc. Prof. Nosáľ.

The growth of diagnostic, therapeutic, teaching, and scientific research activities has also led to an increase in administrative demands. Therefore, the secretariat of the Clinic of Neurology has been expanded, currently including Petra Ilovská (JFMED) and Ing. Anna Ballová and Mgr. Michaela Veterníková (University Hospital). In 2018, the head nurse position of the department changed, with Mgr. Mária Kurhajcová appointed as Head Nurse, and since 2019 Mgr. Helena Lizuchová has been Ward Nurse.

The Clinic of Neurology, JFMED CU and Martin University Hospital, is accredited for postgraduate specialisation training in Neurology. At present, about 40 physicians from all over Slovakia are enrolled in this training. The department is also accredited for doctoral (PhD) studies in both full-time and part-time forms in the study programme Neurology. Currently, 6 doctoral students are enrolled. The department is accredited to conduct habilitation and professorial appointment procedures in Neurology for the award of the academic titles Associate Professor and Professor.

Prof. Kurča currently has a Hirsch index of 16 and 751 citations recorded in prestigious international citation databases. He is a member of the editorial board of Česká a slovenská neurologie a neurochirurgie and the core editorial board of Neurologie pro praxi, and is also an invited reviewer for many international scientific journals. Assoc. Prof. Sivák is a member of the editorial board of Česká a slovenská neurologie a neurochirurgie and the wider editorial board of Neurologie pro praxi. Assoc. Prof. Kantorová and Assoc. Prof. Nosáľ are members of the editorial board of Neurológia. Prof. Kurča and Assoc. Prof. Nosáľ hold the prestigious membership of FESO (Fellow of the European Stroke Organisation). Prof. Kurča is a member of the committee of the Slovak Neurological Society and of its Cerebrovascular and Neuromuscular Sections.

Assoc. Prof. Nosáľ is a committee member of the Cerebrovascular Section, and Dr. Grofik is a member of the Extrapyramidal Section. Prof. Kurča also serves as the Regional Neurology Specialist for the Žilina Self-Governing Region. He is also a member of the Neurology Subject Committees of the Faculty of Medicine, Palacký University in Olomouc; Masaryk University in Brno; and Comenius University in Bratislava.

As of 2022, the Clinic of Neurology at the Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, and Martin University Hospital is an internationally recognised centre with strong prospects for growth in all areas.