Neurology

Since Sir Run Run Shaw Hospital was founded in 1994, the Department of Neurology has always been an important part of the Department of Internal Medicine. Under the joint guidance of Chinese and American experts and through the collective efforts of colleagues in the department, Neurology gradually became an independent department. After our hospital passed its first JCI accreditation in 2009, the rapid development of the hospital led to a marked increase in the Neurology outpatient volume. The department gradually accumulated a broader patient base, laying a solid foundation for the subsequent development of subspecialty centers and enabling diversified development. During the department’s development, Neurology established multiple specialized disease diagnosis and treatment centers. In 2007, it established the first spontaneous intracranial hypotension diagnosis and treatment center in China. It took the lead in China in implementing standardized diagnostic and treatment procedures for spontaneous intracranial hypotension, introduced spinal MR myelography as a new non-invasive technology for localizing cerebrospinal fluid leaks, combined CTM/MRM and other technologies to accurately locate leak sites, and used targeted epidural blood patches to repair spinal CSF leak sites, greatly improving the cure rate of patients with low intracranial pressure. In December 2008, Sir Run Run Shaw Hospital established a stroke center. In December 2011, it passed JCI Primary Stroke Center certification, becoming the first stroke center in China to pass this certification. In 2018, it received the title of ‘Five-Star Advanced Stroke Center’ from the Stroke Prevention and Treatment Engineering Committee of the National Health Commission, and in 2021 it passed the re-evaluation for an Advanced Stroke Center. In 2016, the department established China’s first botulinum toxin treatment center, which is also the largest dystonia diagnosis and treatment center in East China. In 2021, the National Standard Center for One-Stop Diagnosis and Treatment of Parkinson’s Disease was established, truly achieving whole-course, standardized, and individualized management for patients with Parkinson’s disease. In the same year, the Sleep Medicine Center was established. We created a database of uncommon sleep disorders, including narcolepsy and rapid eye movement sleep behavior disorder. Among these, the number of narcolepsy cases is among the highest in the province. In 2022, the Epilepsy Center successfully passed the review and was officially designated a National Level II Epilepsy Center. In the same year, we received approval for the National Advanced Cognitive Impairment Diagnosis and Treatment Center.

Under the joint guidance of Chinese and American experts and through the collective efforts of colleagues in the department, Neurology has developed into a vigorous and dynamic team. It currently has five wards at the Qingchun Campus, Qiantang Campus, Grand Canal Campus, Shaoxing Campus, and Shuangling Campus, with more than 140 authorized beds, an average annual outpatient volume of 200,000 visits, and more than 8,000 inpatient admissions annually. There are currently 70 employees, including 46 clinical physicians and 24 electrophysiology technicians; 23 are senior professional and technical personnel, 31 hold doctoral degrees, and 22 hold master’s degrees. The diseases diagnosed and treated by the department cover multiple subspecialty areas, including cerebrovascular disease, movement disorders, various types of headache and spontaneous intracranial hypotension, sleep disorders, epilepsy, peripheral neuropathies and muscle pathology, vertigo, neuroimmunology, and cognitive impairment. The level of diagnosis and treatment in some subspecialties is leading within the province and even nationally. The Neurology management team places great importance on talent development and has repeatedly sent young and mid-career physicians to leading universities and hospitals in the United States, the United Kingdom, South Korea, Japan, and other countries for study and further training. It has established friendly cooperative relationships with these universities and hospitals.

Guided by a department culture of pragmatism, steadiness, openness, and harmony, the team provides compassionate and skilled medical care, pursues excellence in academic work, remains tireless in teaching, and advances the department steadily. In the new era, with new goals and a new journey ahead, and guided by the new requirements for the hospital’s high-quality development, the Department of Neurology will move forward with a spirit of vigorous endeavor, make full use of its own strengths, take the enhancement of subspecialty development as a lever, building up strengths in key disease areas as a breakthrough, and improving clinical research capacity as a priority. It will make full use of the collaborative advantages of basic research platforms, establish a favorable academic ecosystem for sustainable development, unite its efforts, and promote the department’s healthy and steady development.

Technical Advantages

Cerebrovascular Disease and Stroke Center: This center integrates stroke emergency care, neurology, neurosurgery, intensive care, neurointervention, rehabilitation medicine, health education, and other disciplines. The team specializes in: 1. emergency care and reperfusion therapy for ischemic stroke; 2. interventional procedures for ischemic cerebrovascular disease; 3. diagnosis and pharmacological treatment of cerebrovascular disease; 4. prevention of cerebrovascular disease and health education; and 5. basic and clinical research on cerebrovascular disease.

Headache and Low-Intracranial-Pressure Diagnosis and Treatment Center: This is the first low-intracranial-pressure center in China and a national leader in the standardized diagnosis and treatment of spontaneous intracranial hypotension. To date, it is the center in China that has treated the largest number of patients with low intracranial pressure. It performs precise localization of spinal CSF leaks, targeted epidural blood patch treatment, and surgical treatment. It conducts research on the brain functional mechanisms of various types of headache, including migraine and medication-overuse headache, and provides pharmacological, neuropsychological, and other treatments. Specialized outpatient clinics for headache and dizziness have been established. The center is a member institution of the Expert Committee of the China Headache Prevention and Control Base and System Development Project.

Movement Disorders and Botulinum Toxin Type A Treatment Center: The Botulinum Toxin Treatment Center integrates clinical medicine, electrophysiology, ultrasound, magnetic resonance imaging, genetic testing, nuclear medicine, and other disciplines. It operates a specialized outpatient clinic for botulinum toxin injections and effectively treats blepharospasm, hemifacial spasm, sialorrhea, and other disorders. In particular, electromyography-guided injection treatment for spasmodic torticollis has greatly improved treatment efficacy, reaching a nationally leading and internationally advanced level.

National Standard Center for One-Stop Diagnosis and Treatment of Parkinson’s Disease: The center provides diagnosis and differential diagnosis for patients with parkinsonism and develops individualized treatment plans. It took the lead in the province in performing deep brain stimulation (DBS) surgery. It provides preoperative assessment and postoperative programming for DBS in patients with moderate-to-advanced Parkinson’s disease, and genetic testing and related counseling for patients with early-onset Parkinson’s disease.

Sleep Medicine Center: The center can perform Type I–III polysomnography, multiple sleep latency testing, the maintenance of wakefulness test, lower-limb immobilization testing, non-invasive ventilator pressure titration, actigraphy, and other examinations. In combination with high-density EEG, brain MRI, CSF orexin level measurement, HLA high-resolution testing, and other genetic examinations, it can precisely diagnose various sleep disorders. A sleep outpatient clinic has been established. The center is currently a member of the Narcolepsy Collaborative Group of the Chinese Sleep Research Society, a sleep technologist training base certified by the Capacity Building Center of the National Health Commission, and the home institution of the vice president and secretary-general of the Zhejiang Sleep Research Society.

Epilepsy Center: The center has been recognized by the Chinese Association Against Epilepsy as a Level II Epilepsy Center. It provides patients with epilepsy with professional assessment, clear diagnosis, comprehensive treatment plans, and long-term follow-up management, helping them control seizures and improve their quality of life. The center operates a specialized epilepsy outpatient clinic and performs long-term video EEG monitoring, PET-CT/MRI functional imaging, genetic testing for hereditary epilepsy, and other examinations. It provides preoperative assessment and surgical treatment for refractory epilepsy.

Cognitive Impairment Center: The center has been recognized by the National Health Commission as a ‘National Advanced Cognitive Impairment Diagnosis and Treatment Center.’ It is a training base for the National Health Commission’s cognitive impairment diagnosis and treatment centers and has standardized and internationally oriented systems for the diagnosis, treatment, rehabilitation, prevention, care, and follow-up of cognitive impairment, as well as advanced medical equipment and technologies, including genetic testing, Aβ-PET testing, cognitive rehabilitation software, transcranial magnetic stimulation, and transcranial direct current stimulation. A memory impairment outpatient clinic has been established to provide individualized diagnosis and treatment and dementia prevention services.

Diagnosis and Treatment of Neuromuscular Pathology and Peripheral Nerve Diseases: The center took the lead in the province in conducting CSF cytology and peripheral nerve and muscle pathology examinations. It specializes in the diagnosis and treatment of hereditary and acquired peripheral neuropathies, hereditary and acquired skeletal muscle disorders, as well as the diagnosis of intracranial infections and leptomeningeal carcinomatosis.

Diagnosis and Treatment of Neuroimmunological and Motor Neuron Diseases: The department was the earliest in Zhejiang Province to establish a specialized neuroimmunology outpatient clinic. It has extensive clinical experience with multiple sclerosis, neuromyelitis optica, myelitis, myasthenia gravis, autoimmune encephalitis, and related difficult and complex disorders. It operates a specialized motor neuron disease outpatient clinic and provides standardized diagnosis and treatment for motor neuron disease spectrum disorders, including amyotrophic lateral sclerosis and progressive muscular atrophy, as well as treatment recommendations, care, and education for patients.

Neuroelectrophysiology: The electromyography laboratory performs nerve conduction velocity studies, electromyography, single-fiber electromyography, repetitive nerve stimulation, F-wave testing, H-reflex testing, evoked potentials, and other examinations, providing a basis for the diagnosis of neuromuscular diseases. The EEG laboratory performs routine EEG, sphenoidal EEG, long-term video EEG, ambulatory EEG, polysomnography, daytime multiple-nap testing, sleep-breathing monitoring, event-related potentials, electronystagmography, and other examinations, as well as transcranial magnetic stimulation therapy.

Academic Status

Ministry of Health Standardized Residency Training Base

National Drug Clinical Trial Base

China’s first stroke center to pass international JCI accreditation

Advanced Stroke Center

National Level II Epilepsy Center

China’s first Botulinum Toxin Treatment Center

National Advanced Cognitive Impairment Diagnosis and Treatment Center

National One-Stop Parkinson’s Disease Diagnosis and Treatment Center

Intracranial Hypotension Diagnosis and Treatment Center

Sleep Medicine Center

Research Achievements

The Department of Neurology organizes its research activities by subspecialty groups. Under the overall coordination and leadership of the department director, and through the efforts of the heads of the various subspecialties, its research strength has developed steadily. The department has undertaken 13 projects funded by the National Natural Science Foundation of China and 15 provincial- and ministry-level projects, and publishes dozens of influential research papers every year. In cerebrovascular disease research, the Department of Neurology has undertaken projects including the ‘Ten Cities and Hundred Hospitals Emergency Rescue Standardized Technology Transformation Project for Critical and Severe Diseases,’ the ‘Study of the Mechanism by Which Calreticulin Affects Ischemic Brain Injury,’ and the ‘Study of the Effects and Mechanisms of Early Sleep Apnea Management on Outcomes of Acute Ischemic Stroke.’ It has achieved important results in both the clinical and basic research of cerebrovascular disease. The department was among the leading institutions in China to conduct the ‘Clinical Study of Targeted Epidural Blood Patch Treatment for Spontaneous Intracranial Hypotension.’ The related research achievement, ‘Research and Promotion of Key Technologies for the Diagnosis and Treatment of Spontaneous Intracranial Hypotension,’ received the Third Prize of the 2021 Zhejiang Provincial Science and Technology Progress Award. In recent years, collaboration with the Zhejiang University Brain Institute on research into the brain mechanisms of migraine and medication-overuse headache has achieved significant results. Movement disorders are a traditional strength of Neurology, which has achieved abundant research results, including multiple national-level research funds and national continuing education projects. The sleep subspecialty has achieved numerous influential results; for example, its research in the fields of narcolepsy and restless legs syndrome has led to the publication of multiple high-quality papers.