Neurology in Turkey – the land of EFNS/ENS 2014: Past and present

May 1, 2014

by Dursun Kırbaş

Neurological sciences has taken its independent form during the last quarter of the 20th century. In the beginning of the 20th century, Neurological sciences have been a part of Internal Medicine, then have developed as the doctors in internal medicine started taking a great interest in Neurology. The very first known neurology specialist is Lofcali Dervis Bey.

Upon his return to the country in 1898, Rasit Tahsin Tugsavul was appointed by the Sultan to make Gulhane Military Junior High School an educational institution to improve knwoledge and manners of military doctors. Within 8 months, Gulhane Hospital was turned into Military Practice School and Hospital. At the same time, Non-military Medical School (Mekteb-i Tıbbiye-i Mülkiye in Ottoman) was in Kadirga. Volunteer teacher of the Mekteb-i Tıbbiye-i Mülkiye was Rasit Tahsin. Lofcali Dervis Bey became Rasit Tahsin Tugsavul’s assistant in non-military medical school.

Non-military Medical School in Kadirga moved to Haydarpasa in 1909. As Pepo Aksiyote gave lectures in Kadirga in 1903, he was appointed to Haydarpasa as an assistant of Rasit Tahsin in 1910.
After Rasit Tahsin, MD, Mazhar Osman was appointed to Gulhane in 1908. Mazhar Osman works abroad with that time’s famous scientists and during and after his time as a head physician in Toptasi Hospital, he sent Sukru Hazim Tiner to Hamburg to work with Nonne in the area of neurology; Ihsan Sukru Aksel to Munich to study Neuropathology with Spielmayer; Ahmet Sukru Emed to Munich for serology; Abdulkadir Cahit to Breslau to work with Foerster in the field of Neurosurgery; and Fahrettin Kerim Gokay to Munich, next to Kraepelin to learn clinical and experimental psychiatry.

During the progression, Toptasi Hospital moved to Resadiye barracks in Bakirkoy and a huge effort was made to make it a great institution as it is today. After Mazhar Osman leaved Neurology Clinic in Gulhane, Prof. Dr. Nazim Sakir Sakar took over this duty.

Sukru Yusuf Sanbas, Rasim adasal, Necmettin Polvan, Sami Ziya Gur’un, Selahattin Dogulu, Giyas Unsal, Nevzat Akabay were educated in Nazim Sakir’s clinic, and as Selahattin Dogulu and Nevzat Akabay stayed in Gulhane; Sukru Yusuf Sanbas, became the first chief of the neurology department in Ankara Numune Hospital, then director of Neurology clinic in Ankara University, Faculty of Medicine while Rasim Adasal became director of the psychiatry department of the prementioned faculty.

In Istanbul, Neurology was founded as an independent department in 1924 in Istanbul University, Faculty of Medicine. Prof. Dr. Hayrullah Diker became the head of the department. With reform movements in 1933, the faculty moved from Haydarpasa to Anatolian side. The neurology clinic of the medical faculty started operating with a 2nd Division in Bakirkoy. Hayrullah Diker and Associate Prof. Dr. Esat Rasit Tugsavul, the son of Rasit Tahsin, worked at neurology department until his death. Hayrullah Diker retired 1941 and Prof. Dr. Fahrettin Kerim Gokay took over his duty as head of the department.

Fahrettin Kerim Gokay, in his autobiography, declares that during university reform movements in 1933, he was appointed as director after his professor assistancy within the staff of Resit Galip and reclaims that such a clinic has never been established.
After Fahrettin Kerim Gokay became governor and mayor of Istanbul, Ihsan Sukru Aksel became director of the clinic between 1949 and 1950. During this period, as the Neurology Department of the medical faculty moved its campus to Cerrahpasa, neurology’s sub-disciplines were formed under the supervision of Prof. Dr. Necmettin Polvan.

Ihsan Sukru Aksel’s book, named, “Neurotrophic Virus, Encephalitis” was published in 1944. This book, which includes Ihsan Sukru Aksel’s 10-year Neuropathology works in Bakirkoy Emrazi Asabiye Hospital, is acknowledged as an important piece of scientific literary work among both national and international ones of that time. At the same year, 1944, Istanbul University, Faculty of Medicine’s academic members wrote a textbook of internal medicine whose 8th chapter is reserved for Neurological Diseases and this chapter was written by Dr. Sukru Hazim Tiner, the chief of Neurology clinic in Bakirkoy Emrazi Asabiye Hospital.

The book contains 500 pages and was published in 1948. Mostly, neuroanatomy and neurophysiology are covered in this book and it can very well be seen the amount of knowledge about neurology in that period of time.

As neurology in Istanbul, Cerrahpasa Faculty of Medicine developed under the supervision of Necmettin Polvan, Sukru Hazim Tiner moves from Bakirkoy to Haseki and founded the neurology department there. As mentioned earlier, in Gulhane Medical School, Nazim Sakir Sakar and his followers and in Ankara Medical School, Sukru Yusuf Saribas, the chief of Ankara Numune Hospital between 1927 and 1945, developed their neurologys departments. In the following years, under the supervision of Prof. Dr. Sami Gur, neurology in Ankara Medical School takes its shape it has now. Gulhane’s faculty member Assoc. Prof. Dr. Selahattin Dogulu wrote, “Clinical Electroencephalography” in the year 1954. Bedriye Kot, who became Assoc. Prof. within the same year, left Cerrahpasa a year later and joined Ege University, Faculty of Medicine’s newly-found Neurology Clinic. Prof. Dr. Bedriye Kot was the one, who founded Ege Medical School Neurology department and kept it operating until 2000s.

Dr. Turgut Zileli, who was educated in Istanbul and did his research in the States, and Dr. Orhan Kalabay came back to Turkey and after that, they took part in founding Hacettepe University, Faculty of Medicine, Department of Neurology.

Prof. Dr. Kenan Tukel left Cerrahpasa to found a department of Neurology in Capa. After the death of Sukru Yusuf Saribas in 1962, Prof. Dr. Sami Gur became the clinical director of neurology in Ankara and founded a department of Neurology in Ankara University, Faculty of Medicine. In Gulhane Military Medical School, after Selahattin Dogulu: Nihat Balkir, who then moved Bursa Uludag University, Faculty of Medicine, S. Akpinar, M. Yardim and Okay Vural became directors of the clinic, respectively. Mehmet Oztopcular continued his work in neurology clinic in Erzurum. Fikret Unsal, after leaving Gulhane military medical school, first started working at Diyarbakir Dicle University Neurology Clinic, and then at Cukurova University Neurology Clinic. Sezer Komsuoglu founded first Karadeniz Technical University, Faculty of Medicine Neurology Department, then Kocaeli University, Faculty of Medicine Neurology Department. The then newly found Dokuz Eylul University, Faculty of Medicine, Department of Neurology in Izmir wass supported by Ege University, Faculty of Medicine, Department of Neurology. In the beginning, Sakir Fadiloglu became the director, then Fethi Idiman and Egemen Idiman gave their support to make it how it is today.

Bursa Uludag University, Faculty of Medicine made it stronger to the year 2000 with the support of Nihat Balkir and Prof. Dr. Erhan Ogul from Istanbul. Talking about Neurology in Turkey is not complete if Prof. Dr. Korkut Yaltkaya of Antalya is left unmentioned. While he was associate professor in Ankara University, Faculty of Medicine, he also starts putting the keystones to make the clinic as it is today.
A similar story is seen in education of hospitals. Right after Toptasi Hospital moved to Bakirkoy, we see Sukru Hazim Tiner, a member of Mazhar Osman team, who improved himself by working with Nonne in Hamburg, as a person in charge of the 9th and the 35th divisions. Sukru Hazim Tiner then continued his duty as chief of neurology department in Haseki and Sisli Etfal Hospitals. After him, A. Sukru Emed followed the same path; for a short period continued to work as the chief of neurology department in Gureba Hospital, then in Haseki Hospital and then moved to Sisli Etfal Hospital. In Bakirkoy, Dr. Faruk Bayulkem and Dr. Yildirim Aktuna took over neurology department chief and head doctor position, respectively. In Haydarpasa Numune Hospital, neurology department was supervised by Dr. Nevzat Esref Bengisu, Dr. Ethem Vassaf Akan and developed even more with Dr. Rasim Hatipoglu. In 1962, with Dr. Fettah Demirhan, we see Dr. Ahmet Caliskan, who is a teacher of many of us, as an assistant, head assistant, and vice-chief of the department. In 1976, Dr. Necati Aydinel became the chief of the clinic. Present staff members were educated during the area of Dr. Necati Aydinel.

After A. Sukru Emed, we find Dr. Coskun Ozdemir, at that time Assoc. Prof., as the chief of neurology department in Haseki Hospital. Dr. Ozdemir stayed in this position for 6 years, then moved to Istanbul University, Neurology chairman position. Dr. Fevzi Akso, followed by Kemal Buyulkem became chief after a brief period of time. After Dr. Dursun Kirbas’ 3.5-year of substitution, Dr. Feriha Ozer was appointed as the chief of the clinic. In Sisli Etfal Hospital, Rasit Tahsin and then Ahmet Sukru Emed became chiefs, respectively. After 1960s, Dr. Ahmet Kursat, Dr. Yildirim Aktuna, and Dr. Baattin Yardimci took over the positions until 1990s. As this deeply rooted tradition continued with Assoc. Prof. Dr. Hulki Forta, the MInistry of Health founded the 2nd clinic. The chief of this newly-found second clinic is Assoc. Prof. Dr. Munevver Celik.

In Ankara, we find Porf. Dr. Sukru Yusuf Saribas of Gulhane MIlitary Medical School as chief of the clinic in Ankara Numune Hospital between 1927 and 1945. Dr. Munif Sanan and Dr. Sabahat Gurcay should not be left unmentioned. Neurology Clinic education started as Prof. Dr. Sami Gur’un was appointed with an extra duty in Ankara University Hospital and this education continues till now under the chief positions of Dr. Nazmi Barlas, Dr. Mukadder Sengir Okan, and Dr. Muhlis Yurdakul.

In 1939, we find Dr. Ismail Ziye Tiregol as the first Neuropsychiatry doctor in Izmir Public Hospital, aka Izmir Ataturk Education and Research Hospital. Until 1960s, Dr. Kemal Osman Bozkurt, after whom an amphitheatre is named by Prof. Dr. Bedriye Kot in Ege University, Faculty of Medicine; from 1960s to 1979, Dr. Bekir Urfali and after Urfali, Dr. Mustafa Basoglu became chief in charge.

Neurology education is partially new within the hospitals sponsored by institutions, such as SSK (Social Security Institution), PTT (State Communication Institution). SSK Samatya (Istanbul) Hospital’s education is supervised by Dr. Halil Ibrahim Bahar, who is also known for his artistic identity, between 1960 and 1989. SSK Okmeydani Neurology’s education is partially new. We also know that from 1981 onwards, education in SSK Goztepe was taken over under the chieftainship of Dr. Gungor Turhan. After 1996, Dr. Nihal Isik took over his position. In Bezmi Alem Valide Sultan Vakıf Gureba Hospital, which belongs to SSK now, as the first neurology doctor Dr. Ahmet Sukru Emed worked for a short period of time and starting from 1932, Dr. Rifat Cagil worked at the outpatient clinic for 33 years. In 1969, Assoc. Prof. Dr. B. Karabet Varvar was appointed as chief of the neurology clinic. From 1981 on, Assoc. Pof. Dr. continueed working as chief of the clinic. In Ankara SS Education Hospital, neurology education is comparably old. There were two neurology clinics in 1964. At the first clinic, Dr. Ali Ihsan Sahinalp; at the second clinic, Dr. Suzan Taner were the chiefs. Dr. Sahinalp wrote a book about EEG, one of the first ones about this topic. After Dr. Sahinalp, Dr. Senay Ozbakir and after Ozbakir went to Numune Hospital, Assoc. Prof. Dr. Fevzi Oztekin took over the posion of chief of the clinic. Neurology education in SSK Tepecik Hospital started in 1978 as Dr. Fatma Turkan Alatan was appointed as chief of the clinic. After the chief’s departure, education halted for a short periof of time. In 1993, education restarted when Dr. Yasar Zorlu became chief of the clinic. In SSK Izmir Education Hospital, education started in 1982 with Assoc. Prof. Dr. Nezihe Ertekin and outpatient clinic started operating with Dr. Faruk Dursunoglu. Today, education continues with Assoc. Prof. Dr. M. Gedizlioglu.