American Board of Psychiatry and Neurology (Child and Adolescent Neurology)
American Board of Psychiatry and Neurology (Epilepsy)
Professional History
I am a child neurologist with expertise in Epilepsy, Clinical Neurophysiology, Neurogenetics, and Fetal/Neonatal Neurology. I am medical director of Epilepsy Genetics, and I am director and co-founder of the CDKL5 Clinic at Boston Children’s Hospital. I additionally see general neurology patients with our amazing nurse practitioners at the Peabody Satellite.
I have extensive experience in clinical care and research for populations of patients with infantile-onset developmental and epileptic encephalopathies, and I lead a clinical research team at Boston Children’s Hospital. I completed a career development award from National Institute of Neurological Disorders and Stroke titled “Diagnosis and genotype-phenotype correlations in early life epilepsy and CDKL5 Deficiency Disorder.” My locally, nationally and internationally collaborative research aims to advance clinical and translational research in CDKL5 Deficiency Disorder and other infantile-onset epilepsy syndromes.
I have experience in observational clinical studies, clinical trials, and translational research. My recent work has helped to characterize genotype-phenotype correlations in infantile-onset epilepsies, and to establish Natural History and outcome measures for this population. I have served as principal investigator for industry-sponsored clinical trials and I wrote my own investigator initiated trial with support from the National Institute of Neurological Disorders and Stroke Clinical Trials Methodology Course.
Approach to Care
I am grateful for the values instilled in me through my medical education at the Mayo Clinic. These include their primary value “The needs of the patient come first” and logo of three interlocking shields representing a model of care based on integrated excellence in clinical practice, education and research.
Being a physician is a blessing and a privilege, and child neurology is a special field. The resilience of children and families gives me strength. I strive to do my best every day for the needs of my patients today and the hope of contributing to better treatments for the future. I am thankful to my patients, their families and my own, and excellent colleagues for all that they do to help me achieve my goals and your goals.
Publications
Cell Population-resolved Multiomics Atlas of the Developing Lung. View Abstract
The natural history of CDKL5 deficiency disorder into adulthood. View Abstract
Modification of a parent-report sleep scale for individuals with CDKL5 deficiency disorder: a psychometric study. View Abstract
Excitatory Cortical Neurons from CDKL5 Deficiency Disorder Patient-Derived Organoids Show Early Hyperexcitability Not Identified in Neurogenin2 Induced Neurons. View Abstract
Bipolar Disorder in a female with CDKL5 Deficiency Disorder: A Case Report. View Abstract
Deletions in the CDKL5 5' untranslated region lead to CDKL5 deficiency disorder. View Abstract
Psychometric evaluation of clinician- and caregiver-reported clinical severity assessments for individuals with CDKL5 deficiency disorder. View Abstract
Caregiver Perspective of Benefits and Side Effects of Anti-Seizure Medications in CDKL5 Deficiency Disorder from an International Database. View Abstract
Effects of ganaxolone on non-seizure outcomes in CDKL5 Deficiency Disorder: Double-blind placebo-controlled randomized trial. View Abstract
CDKL5 Deficiency Disorder: Some Lessons Learned 20 Years After the First Description. View Abstract
Timing the clinical onset of epileptic spasms in infantile epileptic spasms syndrome: A tertiary health center's experience. View Abstract
Adapting a measure of gross motor skills for individuals with CDKL5 deficiency disorder: A psychometric study. View Abstract
Long-term treatment with ganaxolone for seizures associated with cyclin-dependent kinase-like 5 deficiency disorder: Two-year open-label extension follow-up. View Abstract
CDKL5 deficiency disorder and other infantile-onset genetic epilepsies. View Abstract
The development, content and response process validation of a caregiver-reported severity measure for CDKL5 deficiency disorder. View Abstract
Utility of Exome Sequencing for Diagnosis in Unexplained Pediatric-Onset Epilepsy. View Abstract
Expanding genotype-phenotype correlations in FOXG1 syndrome: results from a patient registry. View Abstract
Ezogabine impacts seizures and development in patients with KCNQ2 developmental and epileptic encephalopathy. View Abstract
Epileptic spasms in CDKL5 deficiency disorder: Delayed treatment and poor response to first-line therapies. View Abstract
Comparison of evoked potentials across four related developmental encephalopathies. View Abstract
Genetic Diagnosis Impacts Medical Management for Pediatric Epilepsies. View Abstract
Genotype-phenotype correlations in SCN8A-related disorders reveal prognostic and therapeutic implications. View Abstract
Wide range of phenotypic severity in individuals with late truncations unique to the predominant CDKL5 transcript in the brain. View Abstract
Electrophysiological biomarkers of brain function in CDKL5 deficiency disorder. View Abstract
International Consensus Recommendations for the Assessment and Management of Individuals With CDKL5 Deficiency Disorder. View Abstract
Assessing the landscape of STXBP1-related disorders in 534 individuals. View Abstract
CDKL5 Deficiency Disorder-Related Epilepsy: A Review of Current and Emerging Treatment. View Abstract
Safety and efficacy of ganaxolone in patients with CDKL5 deficiency disorder: results from the double-blind phase of a randomised, placebo-controlled, phase 3 trial. View Abstract
CDKL5 deficiency disorder: clinical features, diagnosis, and management. View Abstract
Towards understanding genetic risk in febrile seizures: innate immunity and neuronal excitability. View Abstract
PIGN encephalopathy: Characterizing the epileptology. View Abstract
Early diagnosis and experimental treatment with fenfluramine via the Investigational New Drug mechanism in a boy with Dravet syndrome and recurrent status epilepticus. View Abstract
Current neurologic treatment and emerging therapies in CDKL5 deficiency disorder. View Abstract
Content Validation of Clinician-Reported Items for a Severity Measure for CDKL5 Deficiency Disorder. View Abstract
Cerebral visual impairment in CDKL5 deficiency disorder: vision as an outcome measure. View Abstract
Generation and characterization of human induced pluripotent stem cells (iPSCs) from three male and three female patients with CDKL5 Deficiency Disorder (CDD). View Abstract
Medulloblastoma in the setting of megalencephaly polymicrogyria polydactyly hydrocephalus. View Abstract
Characterization of the GABRB2-Associated Neurodevelopmental Disorders. View Abstract
Modelling and treating GRIN2A developmental and epileptic encephalopathy in mice. View Abstract
Biological concepts in human sodium channel epilepsies and their relevance in clinical practice. View Abstract
Genetic diagnoses in epilepsy: The impact of dynamic exome analysis in a pediatric cohort. View Abstract
CDKL5 deficiency disorder: Relationship between genotype, epilepsy, cortical visual impairment, and development. View Abstract
Severity Assessment in CDKL5 Deficiency Disorder. View Abstract
PLPHP deficiency: clinical, genetic, biochemical, and mechanistic insights. View Abstract
Cannabis for refractory epilepsy in children: A review focusing on CDKL5 Deficiency Disorder. View Abstract
Spectrum of neurodevelopmental disease associated with the GNAO1 guanosine triphosphate-binding region. View Abstract
A Recurrent De Novo PACS2 Heterozygous Missense Variant Causes Neonatal-Onset Developmental Epileptic Encephalopathy, Facial Dysmorphism, and Cerebellar Dysgenesis. View Abstract
Clinical and Functional Characterization of the Recurrent TUBA1A p.(Arg2His) Mutation. View Abstract
A Recurrent De Novo PACS2 Heterozygous Missense Variant Causes Neonatal-Onset Developmental Epileptic Encephalopathy, Facial Dysmorphism, and Cerebellar Dysgenesis. View Abstract
Should patients with complex febrile seizure be admitted for further management? View Abstract
Characterization of a novel variant in siblings with Asparagine Synthetase Deficiency. View Abstract
Imaging features and prognostic factors in fetal and postnatal torcular dural sinus malformations, part II: synthesis of the literature and patient management. View Abstract
Imaging features and prognostic factors in fetal and postnatal torcular dural sinus malformations, part I: review of experience at Boston Children's Hospital. View Abstract
A randomized controlled trial of levodopa in patients with Angelman syndrome. View Abstract
Use of the ketogenic diet to manage refractory epilepsy in CDKL5 disorder: Experience of >100 patients. View Abstract
Genetics and genotype-phenotype correlations in early onset epileptic encephalopathy with burst suppression. View Abstract
A Model Program for Translational Medicine in Epilepsy Genetics. View Abstract
BRAT1 mutations present with a spectrum of clinical severity. View Abstract
Pediatric anti-Hu-associated encephalitis with clinical features of Rasmussen encephalitis. View Abstract
SCN2A encephalopathy: A major cause of epilepsy of infancy with migrating focal seizures. View Abstract