Tag Archive for: Gaillard

illustration of the brain on black background

Children’s National Hospital to host 35th Annual Pediatric Neurology Update

illustration of the brain on black backgroundThe Divisions of Neurology and Neurosurgery at Children’s National Hospital are proud to host the 35th Annual Pediatric Neurology Update course.

Chair Elizabeth Wells, MD; Co-Chairs, Marc DiSabella, DO, John Schreiber, MD, William D. Gaillard, MD, Robert Keating, MD

The course attracts a national audience and brings together neuroscience clinicians and pediatricians in the Washington, D.C. and Mid-Atlantic region.

Guest speakers include Annapurna Poduri, MD, MPH, Deputy Director for NINDS, Emily Freilich, MD, from the FDA and Conor Mallucci, MBBS, Chief of Neurosurgery at Alder Hays, England.

This year’s course highlights 3 major areas:

  • Updates in Epilepsy
  • Innovations in Vascular Neurosurgery and Neurointerventional Radiology
  • Addressing Mental and Behavioral Health in Neurological Conditions

We invite you to join us for presentations from experts in the field during this full-day, CME accredited event on April 10, 2025. This is a hybrid event that will be held virtually or in-person at the Children’s National Research & Innovation Campus.

For more information and to register, visit ChildrensNational.org/NeurologyUpdate.

William D. Gaillard, MD

William D. Gaillard, MD, receives 2024 Clinical Science Research Award from AES

William D. Gaillard, MD

For his groundbreaking research in pediatric epilepsy care, William D. Gaillard, MD, has been named the recipient of the 2024 Clinical Science Research Award by the American Epilepsy Society (AES).

For his groundbreaking research in pediatric epilepsy care, William D. Gaillard, MD, has been named the recipient of the 2024 Clinical Science Research Award by the American Epilepsy Society (AES).

Dr. Gaillard serves as chief of the Divisions of Child Neurology and of Epilepsy and Neurophysiology, director of the Comprehensive Pediatric Epilepsy Program and associate director of the Center for Neuroscience Research at Children’s National Hospital. He also is Professor of Pediatrics and Neurology at the George Washington University School of Medicine, adjunct Professor of Neurology at Georgetown University and adjunct professor of Hearing and Speech Sciences at the University of Maryland, College Park. He holds the endowed Chair for Epilepsy and Neurophysiology.

About the award

This esteemed award, presented annually at AES, recognizes leading researchers whose work significantly contributes to the understanding and treatment of epilepsy. Dr. Gaillard’s groundbreaking research, which combines advanced imaging techniques with a focus on epilepsy and cognitive systems, has paved the way for important advances in the field of pediatric epilepsy care.

“It is a great honor to be recognized by my peers for the research I have conducted to improve the lives of children with epilepsy,” said Dr. Gaillard.

Dr. Gaillard’s work continues to have a profound impact on the field of pediatric neurology and epilepsy research. His commitment to advancing both scientific understanding and clinical outcomes for children with epilepsy has earned him the highest accolades from the AES. This recognition not only honors his past achievements but also highlights his ongoing contributions to the field, ensuring a brighter future for pediatric epilepsy care.

Dr. Gaillard, Dr. Schreiber and Dr. Cohen from Children’s National Hospital at the 2024 American Epilepsy Society meeting.

Advancing epilepsy care: Highlights from the 2024 American Epilepsy Society Conference

Dr. Gaillard, Dr. Schreiber and Dr. Cohen from Children’s National Hospital at the 2024 American Epilepsy Society meeting.

Dr. Gaillard, Dr. Schreiber and Dr. Cohen from Children’s National Hospital at the 2024 American Epilepsy Society meeting.

The 2024 American Epilepsy Society (AES) conference, held over five days, brought together healthcare professionals, scientists and industry leaders from around the globe. This annual event focuses on advancing outcomes for people with epilepsy through educational sessions, cutting-edge research and the latest technological innovations.

Recognized amongst his peers as an international leader in epilepsy research, William D. Gaillard, M.D., was honored with the 2024 Clinical Science Research Award at this year’s meeting. His pioneering work has significantly enhanced our understanding of epilepsy’s impact on brain structure and has led to improvements in surgical interventions and patient outcomes. Dr. Gaillard’s ongoing contributions to enhancing the lives of children with epilepsy earned him the Society’s most prestigious research award.

Dr. Gaillard serves as chief of the Divisions of Child Neurology and of Epilepsy and Neurophysiology, Director of the Comprehensive Pediatric Epilepsy Program and Associate Director of the Center for Neuroscience Research at Children’s National Hospital.

In addition to Dr. Gaillard, experts from the Comprehensive Pediatric Epilepsy Program at Children’s National were invited to present their research, insights and innovations during the conference. As a recognized Level 4 epilepsy center by the National Association of Epilepsy Centers, the program’s collaborative team is recognized worldwide for their leadership in improving the lives of children with epilepsy through personalized care, advanced technology and groundbreaking research.

Highlights from AES 2024 include:

Sanam Zarei, M.D., Children’s National Hospital Neurology fellow, presenting a poster at AES 2024.

Dr. Zarei, Children’s National Hospital Neurology fellow, presenting a poster at AES 2024.

Poster presentations:

  • Asymmetrical Hippocampal-cortical Connectivity Along Lateral-Medial Axis in Pediatric Focal Epilepsy Patients by Hua Xie, Ph.D., Chloe A. Hooker, William D. Gaillard, M.D.
  • Comorbidities and Concerns in Hypothalamic Hamartoma: Results of an International Caregiver Survey by Nathan Cohen, M.D.
  • Automated and Interpretable Detection of Hippocampal Sclerosis in temporal lobe epilepsy: AID-HS by Nathan Cohen, M.D.
  • Characteristics and Outcomes of Pediatric Patients with Prolonged Convulsive Status Epilepticus by William D. Gaillard, M.D.
  • High Accuracy for Detecting Tonic Clonic seizures (TCSs) Using an Apple Watch Seizure Detector by Dewi Depositario-Cabacar, M.D., William Gaillard, M.D.
  • Patient and Pre-surgical Testing Characteristics Contributing to Duration of Evaluation: Identifying Best Practices and Opportunities to Streamline Pediatric Epilepsy Surgery Evaluation by Dewi Depositario-Cabacar, M.D., William Gaillard, M.D.
  • Seizure Burden in Infants with Hemimegaloencephaly pre- and post Staged Transarterial Embolization by Ersida Buraniqi, M.D., Shani Israel, Lindsay Ruffini, CPNP, CPNP-AC, CPNP-PC, Tammy Tsuchida, M.D., Ph.D., Tayyba Anwar, M.D.
  • Acute Postoperative Seizures (APOS) in Pediatric Epilepsy Surgery Occurring Less Than 7 Days versus Greater Than 7 to 30 Days: Is There a Difference in Long Term Outcome? by Sanam Zarei, M.D., Kathryn Havens, PA-C, Nathan Cohen, M.D., John Schreiber, M.D., Thuy-Anh Vu, M.D., William Gaillard, M.D., Dewi Depositario-Cabacar, M.D.

Invited speakers and topics:

  • Speaker: John Schreiber, M.D., Moving Forward: Epilepsies with Concomitant Movement Disorders
  • Speaker: Laura Tochen, M.D., Moving Forward: Epilepsies with Concomitant Movement Disorders
  • Speaker: William Gaillard, M.D., US Health Care Inequities for People with Epilepsy
  • Session Moderator: Nathan Cohen, M.D., Neuroimaging

Learn more about the Comprehensive Pediatric Epilepsy Program at Children’s National Hospital.

2024-25 US News Badges

Children’s National again ranked among the best in the nation by U.S. News & World Report

2024-25 US News BadgesChildren’s National Hospital in Washington, D.C., was ranked as a top hospital in the nation by the U.S. News & World Report 2024-25 Best Children’s Hospitals annual rankings. This marks the eighth straight year Children’s National has made the Honor Roll list. The Honor Roll is a distinction awarded to only 10 children’s hospitals nationwide.

This year, U.S. News ended ordinal rankings on its Honor Roll. Instead of assigning a numerical rank from 1 to 10, all hospitals on the Honor Roll will be recognized as having attained the highest standards of care in the nation.

In addition, Children’s National tied for #1 pediatric hospital in the Mid-Atlantic region, which includes New York, New Jersey, Delaware, Pennsylvania, the District of Columbia, West Virginia and Virginia. It’s also best in the Mid-Atlantic in Neonatology.

For the fourteenth straight year, Children’s National ranked in 10 specialty services. New this year, U.S. News included behavioral health as a service line in the rankings. Since it’s the first year, there are no ordinal rankings for behavioral health, but the Children’s National program was named one of the top 50 programs in the country.

“In my first year here, I witnessed what makes Children’s National so special — our commitment to collaboration, empowering one another, and charting a bold path forward for pediatric care,” said Michelle Riley-Brown, MHA, FACHE, president and chief executive officer of Children’s National. “I’m proud U.S. News again recognized Children’s National as one of the top in the nation and the highest-ranked pediatric hospital in D.C., Maryland and Virginia. Together, we’ll continue to push the boundaries of care, research and innovation to make a difference for those who matter most — the kids.”

The annual rankings are the most comprehensive source of quality-related information on U.S. pediatric hospitals and recognizes the nation’s top 50 pediatric hospitals based on a scoring system developed by U.S. News.

“For nearly two decades, U.S. News has published Best Children’s Hospitals to empower the parents and caregivers of children with complex medical needs,” said Ben Harder, chief of health analysis and managing editor at U.S. News. “Children’s hospitals appearing on the U.S. News Honor Roll have a track record of delivering unparalleled specialized care.”

The bulk of the score for each specialty service is based on quality and outcomes data. The process includes a survey of relevant specialists across the country, who are asked to list hospitals they believe provide the best care for patients with the most complex conditions.

The Children’s National specialty services that U.S. News ranked in the top 10 nationally are:

The other four specialties ranked among the top 50 are Behavioral Health, Cardiology and Heart Surgery, Pulmonology and Lung Surgery, and Urology.

Magnetic resonance imaging of a brain with seizures

Making pediatric epilepsy surgery more accessible

Magnetic resonance imaging of a brain with seizures

Pediatricians play a vital role in boosting the use of epilepsy surgery for better patient outcomes.

Despite proven safety, efficacy and cost effectiveness, surgery for pharmacoresistant epilepsy remains one of the most underutilized, evidence-based treatments in modern medicine. Pediatricians are key stakeholders for increasing epilepsy surgical utilization.

A recent commentary from Children’s National Hospital experts — led by Nathan Cohen, M.D., neurologist; Chima Oluigbo, M.D., neurosurgeon; and William D. Gaillard, M.D., chief of Neurology — offers a new perspective that highlights the issue and offers practical solutions to increase primary care physician comfort in the referral of patients for epilepsy surgery.

“Pediatricians should feel empowered to open discussions with epilepsy patients and their families about the possibility of surgery,” the authors write. “Through partnership with managing neurologists and early referral to epilepsy surgery centers, together we can begin to dismantle the significant barriers to access. Only by overcoming our own fears of initiating these discussions can we offer hope to those patients and families who need it the most.”

You can read the full commentary, “Breaking Barriers to Pediatric Epilepsy Surgery Utilization,” in The Journal of Pediatrics.

U.S. News Badges

Children’s National Hospital ranked #5 in the nation on U.S. News & World Report’s Best Children’s Hospitals Honor Roll

U.S. News BadgesChildren’s National Hospital in Washington, D.C., was ranked #5 in the nation on the U.S. News & World Report 2023-24 Best Children’s Hospitals annual rankings. This marks the seventh straight year Children’s National has made the Honor Roll list. The Honor Roll is a distinction awarded to only 10 children’s hospitals nationwide.

For the thirteenth straight year, Children’s National also ranked in all 10 specialty services, with eight specialties ranked in the top 10 nationally. In addition, the hospital was ranked best in the Mid-Atlantic for neonatology, cancer, neurology and neurosurgery.

“Even from a team that is now a fixture on the list of the very best children’s hospitals in the nation, these results are phenomenal,” said Kurt Newman, M.D., president and chief executive officer of Children’s National. “It takes a ton of dedication and sacrifice to provide the best care anywhere and I could not be prouder of the team. Their commitment to excellence is in their DNA and will continue long after I retire as CEO later this month.”

“Congratulations to the entire Children’s National team on these truly incredible results. They leave me further humbled by the opportunity to lead this exceptional organization and contribute to its continued success,” said Michelle Riley-Brown, MHA, FACHE, who becomes the new president and CEO of Children’s National on July 1. “I am deeply committed to fostering a culture of collaboration, empowering our talented teams and charting a bold path forward to provide best in class pediatric care. Our focus will always remain on the kids.”

“I am incredibly proud of Kurt and the entire team. These rankings help families know that when they come to Children’s National, they’re receiving the best care available in the country,” said Horacio Rozanski, chair of the board of directors of Children’s National. “I’m confident that the organization’s next leader, Michelle Riley-Brown, will continue to ensure Children’s National is always a destination for excellent care.”

The annual rankings are the most comprehensive source of quality-related information on U.S. pediatric hospitals and recognizes the nation’s top 50 pediatric hospitals based on a scoring system developed by U.S. News.

“For 17 years, U.S. News has provided information to help parents of sick children and their doctors find the best children’s hospital to treat their illness or condition,” said Ben Harder, chief of health analysis and managing editor at U.S. News. “Children’s hospitals that are on the Honor Roll transcend in providing exceptional specialized care.”

The bulk of the score for each specialty service is based on quality and outcomes data. The process includes a survey of relevant specialists across the country, who are asked to list hospitals they believe provide the best care for patients with the most complex conditions.

The eight Children’s National specialty services that U.S. News ranked in the top 10 nationally are:

The other two specialties ranked among the top 50 were cardiology and heart surgery, and urology.

William Gaillard

William D. Gaillard, M.D., named as first endowed Professor of Epilepsy and Neurophysiology

William GaillardChildren’s National Hospital named William D. Gaillard, M.D., as the hospital’s first endowed Professor of Epilepsy and Neurophysiology.

Dr. Gaillard serves as Division Chief of Child Neurology, Epilepsy and Neurophysiology, Director of the Comprehensive Pediatric Epilepsy Program and Associate Director of the Center for Neuroscience Research at Children’s National Hospital. He also is Professor of Pediatrics and Neurology at the George Washington University School of Medicine, Professor of Neurology at Georgetown University and Adjunct Professor of Hearing and Speech Sciences at the University of Maryland, College Park.

About the award

Dr. Gaillard joins a distinguished group of 42 Children’s National physicians and scientists who are endowed chairs. Professorships at Children’s National advance groundbreaking work on behalf of children and their families and foster new discoveries and innovations in pediatric medicine. These prestigious appointments carry honor and reflect the recipient’s achievements and donor’s forethought to advance and sustain knowledge.

Dr. Gaillard is an internationally recognized expert in advanced structural and functional imaging, with a focus on examining the effects of epilepsy on brain structure and function. His pioneering work with functional imaging has changed clinical practice for patients with epilepsy, impacted structural and functional imaging methods and provided fundamental insights on brain plasticity. Dr. Gaillard’s research is improving patient outcomes and the lives of children with epilepsy.

Donors Betsy Williams and Tom Moore, through their vision and generosity, will ensure that Dr. Gaillard and future holders of this professorship can launch bold, new initiatives to rapidly advance the field of pediatric epilepsy and neurophysiology, elevate our leadership and improve the lifetimes of children with epilepsy and seizure disorders.

“This Professorship is a great honor and opportunity for our team and for the future of pediatric epilepsy medicine,” says Dr. Gaillard. “Thanks to Betsy, Tom and the Hess Foundation’s generosity, we can continue to invest in people and programs that show promise. We can have the flexibility to respond to the needs of our current patient families and prepare for those that will need us tomorrow. We are forever grateful.”

About the donors

Betsy and Tom are parents, members of the Epilepsy Council at Children’s National and long-time supporters. To acknowledge their gratitude and respect for Dr. Gaillard and the comprehensive team he’s built, the Professorship will be named for Dr. Gaillard in the future.

US News Badges

Children’s National named to U.S. News & World Report’s Best Children’s Hospitals Honor Roll

US News BadgesChildren’s National Hospital in Washington, D.C., was ranked No. 5 nationally in the U.S. News & World Report 2022-23 Best Children’s Hospitals annual rankings. This marks the sixth straight year Children’s National has made the list, which ranks the top 10 children’s hospitals nationwide. In addition, its neonatology program, which provides newborn intensive care, ranked No.1 among all children’s hospitals for the sixth year in a row.

For the twelfth straight year, Children’s National also ranked in all 10 specialty services, with seven specialties ranked in the top 10.

“In any year, it would take an incredible team to earn a number 5 in the nation ranking. This year, our team performed at the very highest levels, all while facing incredible challenges, including the ongoing pandemic, national workforce shortages and enormous stress,” said Kurt Newman, M.D., president and chief executive officer of Children’s National. “I could not be prouder of every member of our organization who maintained a commitment to our mission. Through their resilience, Children’s National continued to provide outstanding care families.”

“Choosing the right hospital for a sick child is a critical decision for many parents,” said Ben Harder, chief of health analysis and managing editor at U.S. News. “The Best Children’s Hospitals rankings spotlight hospitals that excel in specialized care.”

The annual rankings are the most comprehensive source of quality-related information on U.S. pediatric hospitals and recognizes the nation’s top 50 pediatric hospitals based on a scoring system developed by U.S. News.

The bulk of the score for each specialty service is based on quality and outcomes data. The process includes a survey of relevant specialists across the country, who are asked to list hospitals they believe provide the best care for patients with the most complex conditions.

The seven Children’s National specialty services that U.S. News ranked in the top 10 nationally are:

The other three specialties ranked among the top 50 were cardiology and heart surgery, gastroenterology and gastro-intestinal surgery, and urology.

brain network illustration

Changing the surgical evaluation of epilepsy

brain network illustrationThe choice between stereoelectroencephalography (SEEG) and subdural evaluation is not mutually exclusive, according to a new opinion piece published in JAMA Neurology.

In their article, Chima Oluigbo, M.D., pediatric epilepsy neurosurgeon, William D. Gaillard, M.D., division chief of Epilepsy and Neurophysiology and Neurology, both at Children’s National Hospital, and Mohamad Z. Koubeissi, M.D., M.A., from The George Washington University Hospital, discuss how the practicing epileptologist requires a profound understanding of the roles of different technologies. It also looks at how to integrate both traditional and emerging paradigms to optimize seizure control. This issue is particularly relevant to choosing the best method of invasive intracranial electroencephalography monitoring in individual cases.

Noting that despite the dramatic increase in SEEG use in recent years, the authors talk about how many patients still benefit from invasive monitoring using subdural grids. Therefore, it is important to define the considerations that should guide decision-making on the choice of SEEG versus subdural monitoring in each patient. The authors expand on their statement explaining that it is critical to define the roles of SEEG vs subdural grid investigation in each patient as subdural grid evaluations are still indicated in specific circumstances.

Additionally combined hybrid deployment of both techniques may be indicated in specific situations. Accommodation should be made to allow customization of the technique chosen to available technical expertise and equipment as well as patient preference.

US News badges

For fifth year in a row, Children’s National Hospital nationally ranked a top 10 children’s hospital

US News badges

Children’s National Hospital in Washington, D.C., was ranked in the top 10 nationally in the U.S. News & World Report 2021-22 Best Children’s Hospitals annual rankings. This marks the fifth straight year Children’s National has made the Honor Roll list, which ranks the top 10 children’s hospitals nationwide. In addition, its neonatology program, which provides newborn intensive care, ranked No.1 among all children’s hospitals for the fifth year in a row.

For the eleventh straight year, Children’s National also ranked in all 10 specialty services, with seven specialties ranked in the top 10.

“It is always spectacular to be named one of the nation’s best children’s hospitals, but this year more than ever,” says Kurt Newman, M.D., president and CEO of Children’s National. “Every member of our organization helped us achieve this level of excellence, and they did it while sacrificing so much in order to help our country respond to and recover from the COVID-19 pandemic.”

“When choosing a hospital for a sick child, many parents want specialized expertise, convenience and caring medical professionals,” said Ben Harder, chief of health analysis and managing editor at U.S. News. “The Best Children’s Hospitals rankings have always highlighted hospitals that excel in specialized care. As the pandemic continues to affect travel, finding high-quality care close to home has never been more important.”

The annual rankings are the most comprehensive source of quality-related information on U.S. pediatric hospitals. The rankings recognize the nation’s top 50 pediatric hospitals based on a scoring system developed by U.S. News. The top 10 scorers are awarded a distinction called the Honor Roll.

The bulk of the score for each specialty service is based on quality and outcomes data. The process includes a survey of relevant specialists across the country, who are asked to list hospitals they believe provide the best care for patients with the most complex conditions.

Below are links to the seven Children’s National specialty services that U.S. News ranked in the top 10 nationally:

The other three specialties ranked among the top 50 were cardiology and heart surgery, gastroenterology and gastro-intestinal surgery, and urology.

Illustration of brain hemispheres

Children use both brain hemispheres to understand language

Illustration of brain hemispheres

New research finds young children process language in both hemispheres of the brain, which could help compensation after a neural injury. This is unlike adults who process most language tasks in one side (usually the left) of their brain’s two hemispheres. It suggests a possible reason why children often seem to recover from brain injury more easily than adults.

New research finds young children process language in both hemispheres of the brain, which could help compensate after a neural injury. The study, published Sept. 8, 2020, in PNAS, says this is unlike adults who process most language tasks in one side (usually the left) of their brain’s two hemispheres. It suggests a possible reason why children often seem to recover from brain injury more easily than adults.

We talked with researcher William D. Gaillard, M.D., chief of the Divisions of Child Neurology, Epilepsy and Neurophysiology at Children’s National Hospital, to discuss the importance of this work.

Q: Tell us a little bit about this study.

A: This is a study we did with our colleagues at Georgetown University Medical Center, using fMRI to map brain regions that are used to process language across development. What we found was that younger children have more bilateral “activation” in language processing regions, the traditional left and homotopic regions in the right. With aging there is consolidation that becomes more left lateralized. This process is most clearly seen in the frontal brain regions, called Broca’s area, where the right activation diminishes over age

Q: Why are these findings important?

A: It’s important because this work provides evidence for how cognitive systems, and the neural networks that underlie them, become consolidated and lateralized over time during development. It provides insights into principles of the development of cognitive systems.

The timeline for lateralization of language systems means that the cognitive systems that sustain language are “plastic” – that is the right hemisphere can sustain language functions in the setting of injury to the left hemisphere until around 10 years of age.

Q: What excites you about this work?

A: This is part of a larger collaborative effort that is mapping out the consolidation of cognitive systems across development (language, visual spatial, memory and working memory). This work will help us to understand the limits of brain plasticity in the setting of injury caused by stroke or epilepsy, which could have benefits down the road to helping patients recover from these types of events.

Q: How is Children’s National leading the ongoing discovery in this space?

A: It is a true team effort. We are working with colleagues at Georgetown University Medical Center, MedStar National Rehabilitation Network and Johns Hopkins Medicine. Team members come from diverse backgrounds and scientific skills. We are one of the leading groups using advanced functional imaging to investigate brain development of critical cognitive systems and their response to brain injury.

You can find the full study published in PNAS. Learn more about the Children’s National Research Institute Center for Neuroscience Research.

 

Youssef Kousa

Dr. Youssef Kousa awarded Pediatric Epilepsy Research Grant

zika virus

The Child Neurology Foundation has awarded Youssef A. Kousa, M.S., D.O., Ph.D., the 2020 Pediatric Epilepsy Research Foundation Shields Research Grant. The funds will support his work on identifying genetic risk factors in congenital Zika syndrome.

The Child Neurology Foundation has awarded Youssef A. Kousa, M.S., D.O., Ph.D., physician-scientist within the Division of Neurology at Children’s National Hospital, and founder and director of the Zika Genetics Consortium, the 2020 Pediatric Epilepsy Research Foundation Shields Research Grant. The funds will support his work on identifying genetic risk factors in congenital Zika syndrome.

This prestigious grant provides $100,000 of research funding to help identify treatments and cures for pediatric neurologic diseases. It will allow Dr. Kousa to test the hypothesis that rare genetic variants in individuals contributed to being affected with congenital Zika syndrome and the severity of the phenotype for those who were affected.

“Despite decades of research, identifying those at greatest risk of congenital infection or being severely affected remains an elusive goal,” says Dr. Kousa. “This research is important because identifying genetic risk or protective factors for developmental brain malformations can help teach us how the brain develops.”

Youssef Kousa

In 2015, Dr. Kousa established the Zika Genetic Consortium to investigate whether maternal and fetal genetic factors can modify the risk of brain injury from congenital infections.

Dr. Kousa adds that this work will provide key insights into maternal and fetal genetic factors that can contribute to brain malformations. The hope is that these insights may one day translate into targeted prevention efforts.

“Dr. Kousa’s project is very creative and has a fantastic opportunity to look at factors of Zika on brain development,” says William D. Gaillard, M.D., division chief of both Epilepsy and Neurophysiology, and Neurology at Children’s National. “This is a very competitive award. It’s a tremendous achievement that few accomplish.”

Children’s National is the leading site for this international research study.

In 2015, Dr. Kousa established the Zika Genetic Consortium to investigate whether maternal and fetal genetic factors can modify the risk of brain injury from congenital infections. Dr. Kousa is the principal investigator of the consortium, which includes 19 co-investigators representing 13 different institutions.

The consortium is bringing together cohorts of 12,000 mother-infant participants retrospectively and prospectively. These cohorts come from 15 international health centers in seven countries in collaboration with partners at the National Institutes of Health, and the Centers for Disease Control and Prevention.

“This support gives us the opportunity to test our hypothesis,” says Dr. Kousa. “We also hope what we continue to learn about Zika can play a role in helping us understand other congenital infections and neurodevelopment diseases.”

William Gaillard

William D. Gaillard, M.D., elected president of the American Epilepsy Society

William Gaillard

“The AES, is one of the oldest neurological professional organizations in the country dedicated to the scientific investigation, exchange of clinical information and eradication of epilepsy and associated disorders, and I’m honored to serve as the new president,” Dr. Gaillard said.

In early December 2019, William D. Gaillard, M.D., chief of the Divisions of Child Neurology, Epilepsy and Neurophysiology at Children’s National Hospital, began his term as president of the American Epilepsy Society (AES) at the annual meeting in Baltimore. The AES is a medical and scientific society with over 4,000 members consisting of clinicians, scientists investigating basic and clinical aspects of epilepsy, and other professionals interested in seizure disorders.

“The AES, is one of the oldest neurological professional organizations in the country dedicated to the scientific investigation, exchange of clinical information and eradication of epilepsy and associated disorders, and I’m honored to serve as the new president,” Dr. Gaillard said.

Dr. Gaillard’s clinical research focuses on the use of advanced imaging to investigate the effect of childhood epilepsy on brain structure and function with an emphasis on cognitive systems. His group also develops and implements imaging strategies to improve epilepsy outcomes.

In addition, Dr. Gaillard, an active participant in AES activities, has served as treasurer and as chair of the Clinical Investigator Workshop and Pediatric Content Committees. He also serves as an associate editor for the journal Epilepsy Research, and as a regular reviewer on AES and Epilepsy Foundation study sections.

As division chief of Child Neurology, Epilepsy and Neurophysiology, Dr. Gaillard directs a team of pediatric specialists who see thousands of patients each year. Dr. Gaillard has worked throughout his career to care for children and young adults with epilepsy from the onset of seizures through novel therapeutic interventions, medication trials and, when appropriate, surgery. Treatment options at Children’s National addresses the full range of the condition, including problems of difficult-to-control epilepsy. Additionally, treatment includes the concurrent social, education and emotional issues faced by children with the condition and their families.

His academic appointments include Professor of Pediatrics and Neurology at George Washington University, Professor of Neurology at Georgetown University, and Professor (adjunct), Hearing and Speech, University of Maryland, College Park.

4th International Symposium on hypothalamic hamartomas

Children’s National co-hosts the 4th International Symposium on hypothalamic hamartomas

The Children’s National Hospital’s Comprehensive Pediatric Epilepsy Program co-hosted the 4th International Symposium on Hypothalamic Hamartomas held in September 2019 in Washington, D.C.

The 2019 Symposium focused on the psychiatric, neuropsychological, neurological and endocrinological comorbidities of Hypothalamic Hamartomas (HH). The participants also looked at treating the whole person – in addition to the tumor – covering the cognitive, physical, emotional and intellectual impacts of HH.

4th International Symposium on hypothalamic hamartomas

Attendees at the 4th International Symposium on Hypothalamic Hamartomas.

Presenters at the Symposium included experts from around the world, such as Children’s National’s Chief of the Divisions of Child Neurology and of Epilepsy and Neurophysiology,, William D. Gaillard, M.D., who moderated the entire event and served as the HH Symposium Chair on the Symposium Steering Committee.  Dr. Gaillard also facilitated a presentation titled “Developing a New Paradigm for Assessing, Surveilling, & Treating HH Comorbidities” and another presentation titled, “Set 3 Year Research Roadmap & Top Priorities.”

Senior Vice President for the Center for Neuroscience & Behavioral Health, Roger Packer, M.D., also presented at the event on treatments being used in other hypothalamic hamartoma syndromes which may possibly have opportunities for success with treatment of HH.

Jake and Dr. Oluigbo

Doctors at Children’s National give Jake his life back

Jake and Dr. Oluigbo

At the age of 17, Jake underwent surgery led by neurosurgeon Chima Oluigbo, M.D., where he conducted a temporal lobe resection, also called temporal lobectomy, that works to lower the number of seizures, make them less severe or stop them completely. The surgery ended up being successful and it worked to greatly improve his overall quality of life.

Since 1969, November has been considered Epilepsy Awareness Month to highlight the importance of recognizing a seizure and promoting seizure first aid. At Children’s National Hospital, doctors in the division of neurology are committed to finding treatments for epilepsy and have done just that by helping Jacob Yates, an 18-year-old patient, get his life back.

For many families the holidays are meant for spending time with loved ones and enjoying the seasonal festivities. However, the holidays were not always a joyous occasion for Jake and his family. Since he was a baby, many of his holidays were spent in a bed due to a brain disorder that caused him to have developmental delays and, at times, up to 17 seizures a day.

“The holidays were always a tough time for the family because Jake would get so excited around Christmas that it would overwhelm his system and induce seizures that took him days to recover from,” says his mom, Jennifer.

Jake was born a preemie and hours after he was born, doctors at his local hospital had identified that he was having trouble breathing. By coincidence, the Children’s National transport team was on-site to take another patient to Children’s National, but once they looked at Jake they immediately took him instead by SkyBear Air Transport, the hospital’s rapid helicopter transport service.

During his stay at Children’s National, Jake was in the neonatal intensive care unit (NICU) for 11 days and was supported by breathing machines to help with respiratory distress and other issues stemming from him being born prematurely.

“If it wasn’t for the Children’s National transport team coincidentally being at our local hospital, Jake wouldn’t have survived staying at that location,” said Jennifer.

After he was taken care of at Children’s National, he was discharged 11 days later, but at the age of three months Jake was still experiencing respiratory issues and was taken back to his local hospital in Charles County.

“When he first arrived back at the University of Maryland Charles Regional Medical Center, the doctors thought he may have had cystic fibrosis, but it came back that perhaps he was suffering from reflux and they put him on medication,” Jennifer recalls. Unfortunately, this was not the cause and it would not be the family’s last visit to the hospital.

By the age of six months, Jake had his first seizure and he was flown back to Children’s National. Over the next year he was repeatedly admitted to the hospital as his seizures had caused him to stop breathing.

Between the ages of 4 to 6 years old, Jake became a patient of William D. Gaillard, M.D., division chief of epilepsy and neurophysiology and Roger Packer, M.D., senior vice president at the Center of Neuroscience and Behavioral Health at Children’s National. After his visit, both doctors recommended surgery, but Dr. Packer recommended that Jake receive an electroencephalogram (EEG), magnetic resonance imaging (MRI) and go through a sleep study first to identify the specific causes of his seizures.

Now on a new medication, his seizures were maintained for the most part, but doctors were still recommending that it was time for surgery. When Jake was 15, his parents re-evaluated the surgery and learned that their son had a 76% chance of being seizure and medication free.

At the age of 17, Jake underwent surgery led by Chima Oluigbo, M.D., neurosurgeon at Children’s National, where he conducted a temporal lobe resection, also called temporal lobectomy, that works to lower the number of seizures, make them less severe or stop them completely. The surgery ended up being successful and it worked to greatly improve his overall quality of life.

Before the surgery, Jake didn’t speak much, experienced anxiety and had difficulty expressing his emotions. He had never told his mother that he loved her. After the surgery, Jake looked at his mother and said, “I love you babe.”

According to Jennifer, since the surgery her son is a completely different person and states that he has been seizure free for over a year. Equally, Jake and the family can now all look forward to the holidays.

“We’re so excited to have him share the holidays,” Jennifer says. “He feels better and it shows through his attitude and the way he responds to things. Words can’t express the gratitude we have for the doctors at Children’s National Hospital. They gave my son his life back.”

William Gaillard

William D. Gaillard, M.D., begins tenure as Second Vice President of the American Epilepsy Society

William Gaillard

William Davis Gaillard, M.D., has begun his term as President-Elect of the American Epilepsy Society (AES), a medical and scientific society with over 4,000 members. Dr. Gaillard’s term started at the end of the society’s annual meeting in New Orleans, La. in December 2018. Dr. Gaillard will become president of the society in 2020.

Dr. Gaillard, an internationally recognized expert in pediatric epilepsy and imaging, is chief of the divisions of Child Neurology, Epilepsy and Neurophysiology, as well as director of the Comprehensive Pediatric Epilepsy Program at the Children’s National Health System in Washington, D.C. He is also the associate director of the DC-IDDC and director of the Intellectual and Developmental Disabilities Research Center (DC-IDDRC) imaging core and associate director of the Center for Neuroscience Research, Children’s Research Institute. His academic appointments include professor of Pediatrics and Neurology at the George Washington University, professor of Neurology at Georgetown University and professor adjunct of Hearing and Speech Sciences University of Maryland, College Park.

As division chief of Child Neurology, Epilepsy and Neurophysiology, Dr. Gaillard directs a team of pediatric specialists who see thousands of patients each year. Dr. Gaillard has worked throughout his career to care for children and young adults with epilepsy from the onset of seizures through novel therapeutic interventions, medication trials and, when appropriate, surgery. Treatment at Children’s National addresses the full range of the condition, including problems of difficult-to-control epilepsy. Additionally, treatment includes the concurrent social, educational and emotional issues faced by children with the condition and their families.

An active member of AES for more than 25 years, Dr. Gaillard has served as treasurer and as chair of the Clinical Investigator Workshop and Pediatric Content Committees. He is an active participant in mentoring activities, including the Junior Investigators Mentoring program and past co-chair of the AES Research and Training Grant Review Study Section. He also serves as an associate editor for the journal Epilepsy Research.

William Gaillard

Putting childhood epilepsy in the spotlight at American Epilepsy Society Meeting

William Gaillard

“We aim to build the evidence base for treatments that are effective specifically for children with epilepsy,” says William D. Gaillard, M.D., chief of Child Neurology, Epilepsy and Neurophysiology, and director of the Comprehensive Pediatric Epilepsy Program.

While epilepsy affects people of all ages, the unique way it manifests in infants, children and adolescents can be attributed in part to the complexities of the growing and developing brain. Researchers from the Children’s National Comprehensive Pediatric Epilepsy Program brought their expertise on the challenges of understanding and treating epilepsy in children to the recent American Epilepsy Society Annual Meeting, the largest professional gathering on epilepsy in the world.

“We aim to build the evidence base for treatments that are effective specifically for children with epilepsy,” says William D. Gaillard, M.D., chief of Child Neurology, Epilepsy and Neurophysiology, and director of the Comprehensive Pediatric Epilepsy Program. “We have learned much from studies in adult populations but technologies like functional MRI allow us to get in-depth understanding, often in non-invasive ways, of precisely how epilepsy is impacting a child.”

Dr. Gaillard was also recently elected to serve as the Second Vice President of the American Epilepsy Society. “The AES is the largest multidisciplinary professional and scientific society dedicated to the understanding, treatment and eradication of epilepsy and associated disorders, and I am honored to serve as the new Second Vice President,” he said.

The team’s presentations and poster sessions focused on several key areas in pediatric epilepsy:

Better ways to see, measure and quantify activity and changes in the brain for children with epilepsy before, during and after surgery

  • Novel applications of fMRI for children with epilepsy
    • Evaluation of an fMRI tool that tracks verbal and visual memory in children with epilepsy – one of the first to capture memory functions in this population of children using noninvasive fMRI;
    • Early study of the use of “resting-state” fMRI to map language skills before epilepsy surgery – an important first step toward noninvasively evaluating children who are too young or neurologically impaired to follow tasks in traditional MRI studies;
  • A study of whether intraoperative MRI, i.e. imaging during neurosurgery, allows for more complete removal of abnormal brain tissue associated with focal cortical dysplasia in children, which is a common cause of intractable epilepsy;
  • A preliminary case review of existing data to see if arterial spin labeling MRI, which measures blood flow to the brain, has potential to identify blood flow changes in specific locations of the brain where seizures occur;
  • An analysis of language laterality – the dominant side of the brain controlling language –  questioning the true reasons that the brains of children with epilepsy have differences in the hemisphere that predominantly controls language;
  • A review of some common assessments of language and working memory that are used pre- and post-operatively to gauge the impacts of pediatric epilepsy surgery. The study found that using multiple assessments, and studying results individually rather than as a group average, resulted in a more complete picture of the outcomes of surgery on these areas of brain function;
  • A preliminary study examining whether continuous EEG monitoring of neonates with hypoxic ischemic encephalopathy, or lack of oxygen to the brain, can be a reliable predictor of neurodevelopmental outcomes while the infant is undergoing therapeutic hypothermia.

“In order to expand our understanding of causes, impacts and outcomes, the range of research is broad given the complexity of epilepsy,” says Madison M. Berl, Ph.D. “This is the only way we can contribute to the goal of providing our colleagues and the families they serve with better resources to make informed decisions about how best to assess and treat pediatric epilepsy.”

The molecular, genetic and biological factors that contribute to onset and severity of pediatric epilepsy

  • A retrospective study of young patients with malformations in cortical development that are important causes of childhood epilepsy;
  • Investigation of a simple saliva test to effectively identify the presence of two common viral infections, human herpesvirus-6B and Epstein-Barr virus, that may be contributors to onset of epilepsy in otherwise normally functioning brains;
  • A preliminary review of the possible relationship between febrile infection-related epilepsy syndrome and the co-occurrence of another neuro-inflammatory condition – hemophagocytic lymphohistiocytosis.

Madison Berl, Ph.D., director of research in the Division of Pediatric Neuropsychology, and a pediatric neuropsychologist in the Comprehensive Pediatric Epilepsy Program, adds, “In order to expand our understanding of causes, impacts and outcomes, the range of research is broad given the complexity of epilepsy. This is the only way we can contribute to the goal of providing our colleagues and the families they serve with better resources to make informed decisions about how best to assess and treat pediatric epilepsy.”

William Gaillard

William D. Gaillard, M.D., elected Second Vice President of the American Epilepsy Society

William Gaillard

William Davis Gaillard, M.D., has been elected second vice president of the American Epilepsy Society (AES), a medical and scientific society with 4,000 members. Dr. Gaillard’s term started at the end of the society’s annual meeting, December 1-5, in Washington, D.C.

“The AES is the largest multidisciplinary professional and scientific society dedicated to the understanding, treatment and eradication of epilepsy and associated disorders, and I am honored to serve as the new Second Vice President.” Dr. Gaillard said.

Dr. Gaillard, an internationally recognized expert in pediatric epilepsy and imaging, is chief of Neurology, Epilepsy and Neurophysiology at Children’s National. He is also the associate director of the DC-IDDC and director of the of the Intellectual and Developmental Disabilities Research Center (DC-IDDRC) imaging core and associate director of the Center for Neuroscience Research, Children’s Research Institute. His academic appointments include professor of Pediatrics and Neurology at George Washington University and professor of Neurology at Georgetown University.

As division chief of Child Neurology, Epilepsy and Neurophysiology, Dr. Gaillard directs a team of pediatric specialists who see thousands of patients each year. Dr. Gaillard has worked throughout his career to care for children and young adults with epilepsy from the onset of seizures through novel therapeutic interventions, medication trials and, when appropriate, surgery. Treatment at Children’s National addresses the full range of the condition, including problems of difficult-to-control epilepsy. Additionally, treatment includes the concurrent social, educational and emotional issues faced by children with the condition and their families.

An active participant in AES activities, Dr. Gaillard has served as treasurer and as chair of the Clinical Investigator Workshop and Pediatric Content Committees. He also serves as an associate editor for the journal Epilepsy Research, and as a regular reviewer on AES and Epilepsy Foundation study sections. Dr. Gaillard will service as first vice president in 2019 and accede to the presidency of AES in 2020.

Exchanging ideas

Exchanging ideas, best practices in China

Exchanging ideas

Physicians from the Children’s National delegation attended the Shanghai Pediatric Innovation Forum in June 2017. Pictured (left to right): Roberta DeBiasi, M.D., Michael Mintz, M.D., Robert Keating, M.D., Lawrence Jung, M.D., Peter Kim, M.D., and Sarah Birch, D.N.P., A.P.R.N.

In late June, a delegation of international pediatric experts from Children’s National Health System journeyed across the world to learn about the practice of pediatric medicine in China and to exchange ideas with colleagues there. Leaders from several of Children’s key specialties joined the delegation, including:

  • Sarah Birch, D.N.P., C.P.N.P.-P.C., director, Advance Practice Nursing
  • Roberta DeBiasi, M.D., chief, Infectious Disease
  • William Gaillard, M.D., chief, Epilepsy and Neurophysiology
  • Lawrence Jung, M.D., chief, Rheumatology
  • Robert Keating, M.D., chief, Neurosurgery
  • Peter Kim, M.D., vice president, Sheikh Zayed Institute for Pediatric Surgical Innovation, associate surgeon-in-chief
  • Yang Liu, Ph.D., director, Center for Cancer and Immunology Research
  • Michael Mintz, Psy.D., developmental psychologist
  • Pamela Mudd, M.D., otolaryngologist
  • Xiaoyan Song, Ph.D., director, Infection Control/Epidemiology

The group, led by Drs. Keating and Gaillard, traveled to China with Children’s Outreach Coordinator John Walsh, whose longtime connections and close familiarity with the pediatric medical community in Hangzhou and Shanghai made the collaboration possible. The team toured several of the largest children’s hospitals in country, including The Children’s Hospital of Zhejiang University School of Medicine in Hangzhou and Shanghai Children’s Medical Center, connecting with pediatric specialists there.

“Some of the most important parts of this trip were the opportunities to exchange ideas and solidify long term relationships that will allow us to work closely with our peers in China as they develop their pediatric programs. The potential is tremendous for unique collaborations between our teams and theirs for research and the development of clinical care improvements for children,” said Roger Packer, M.D., senior vice president of the Center for Neuroscience and Behavioral Medicine, who joined the delegation in Beijing.

A keynote lecture and more at the 3rd China International Forum on Pediatric Development

The delegation also was honored with an invitation to participate in the 3rd China International Forum on Pediatric Development. The forum is one of the largest pediatric focused meetings in the country and is led by all the major children’s hospitals in China, including those in Beijing and Shanghai. Close to 4,000 pediatricians attended the meeting, and presenters included esteemed international leaders in pediatric medicine from around the world.

Dr. Packer delivered one of the opening keynote lectures, entitled, “Translation of molecular advances into care: the challenge ahead for children’s hospitals.” His talk focused on the tremendous promise and significant challenges posed by the latest scientific advances, through the lens of a neurologist.

“Across the world, we are looking at the same challenges: How can we use scientific advances to find better outcomes? How can we financially support the new types of interventions made possible by these molecular biologics insights when they can cost millions of dollars for one patient?”

“There’s palpable excitement that these new developments will give us potential therapies we never dreamed about before, ways to reverse what we initially thought was irreversible brain damage, ways to prevent severe illnesses including brain tumors, but the issue is how to turn this promise into reality. That’s a worldwide issue, not simply a single country’s issue,” he continued.

He also flagged mental health and behavioral health as a crucial, universal challenge in need of addressing on both sides of the Pacific.

The Children’s National delegation, including Drs. DeBiasi, Song, Keating, Gaillard and Packer were also honored to share their insight in a series of specialty-specific breakout sessions at the Forum.

Overall, the long journey opened a dialogue between Children’s National and pediatric care providers in China, paving the way for future discussion about how to learn from each other and collaborate to enhance all institutions involved.

pill bottles and pills

Surprising consensus on pediatric anti-epilepsy meds

A study that includes William D. Gaillard, M.D., among its authors indicates that U.S. doctors appear to have reached an unexpected consensus about which anti-seizure medicine to prescribe to their pediatric patients.

The number of available anti-seizure medications has exploded in the past two decades, going from just a handful of medicines available in the 1990s to more than 20 now. Once the Food and Drug Administration (FDA) approves each new medicine based on trials in adults, it’s available for clinicians to prescribe off-label to all age groups. However, says William D. Gaillard, M.D., division chief of Child Neurology and Epilepsy, Neurophysiology and Critical Care Neurology at Children’s National Health System, trials that lead to FDA approval for adults do not provide any information about which medications are best for children.

“With so many medications and so little data,” Dr. Gaillard says, “one might think doctors would choose a wider variety of medicines when they prescribe to children with epilepsy.”

However, the results from a recent study that included Dr. Gaillard and colleagues, published online in Pediatric Neurology on June 27, 2017, show otherwise. The study indicates that doctors in the United States appear to have reached an unexpected consensus about which medication to prescribe for their pediatric patients.

The study is part of a broader effort to collect data on the youngest epilepsy patients – those younger than 3 years old, the age at which epilepsy most often becomes evident. As part of this endeavor, researchers from 17 U.S. pediatric epilepsy centers enrolled in the study 495 children younger than 36 months old who had been newly diagnosed with non-syndromic epilepsy (a condition not linked to any of the commonly recognized genetic epilepsy syndromes).

The researchers mined these patients’ electronic medical records for information about their demographics, disease and treatments. About half of the study participants were younger than 1 year old when they were diagnosed with epilepsy. About half had disease marked by focal features, meaning that their epilepsy appeared to originate from a particular place in the brain. Nearly all were treated with a single medication, as opposed to a cocktail of multiple medicines.

William Gaillard

“This study identifies current practices, but whether those practices are correct is a separate question,” explains Dr. Gaillard. “Just because a medication is used commonly doesn’t mean it is the best medication we should be using.”

Of those treated with a single medication, nearly all were treated with one of five medicines: Levetiracetam, oxcarbazepine, phenobarbital, topiramate and zonisamide. However, the data showed a clear prescribing preference. About 63 percent of the patients were prescribed levetiracetam as a first choice. By contrast, oxcarbazepine and phenobarbital, the next most frequently prescribed medicines, were taken by patients as a first choice by a mere 14 percent and 13 percent respectively.

Even more striking, of the children who were not prescribed levetiracetam initially but required a second medication due to inadequate efficacy or unacceptable side effects, 62 percent also received this medication. That made levetiracetam the first or second choice for about 74 percent of all the children in the study, despite the availability of more than 20 anti-seizure medications.

It’s not clear why levetiracetam is such a frequent choice in the United States, says Dr. Gaillard. However, in its favor, the drug is available in a liquid formulation, causes no ill effects medically and can be started intravenously if necessary. Studies have shown that it appears to be effective in controlling seizures in about 40 percent of infants.

Yet, levetiracetam’s market dominance appears to be a North American phenomenon, the study authors write. A recent international survey that Dr. Gaillard also participated in suggests that outside of this continent, carbazepine and oxcarbazepine were the most frequently prescribed medications to treat focal seizures.

What’s really necessary, Dr. Gaillard says, is real data on efficacy for each of the medications commonly prescribed to pediatric epilepsy patients – a marked vacuum in research that prevents doctors from using evidence-based reasoning when making medication choices.

“This study identifies current practices, but whether those practices are correct is a separate question,” he explains. “Just because a medication is used commonly doesn’t mean it is the best medication we should be using.”

To answer that question, he says, researchers will need to perform a head-to-head clinical trial comparing the top available epilepsy medications in children. This study sets the stage for such a trial by identifying which medications should be included.

“Uncontrolled pediatric epilepsy can have serious consequences, from potential problems in development to a higher risk of death,” Dr. Gaillard says. “You want to use the optimal medicine to treat the disease.”