Summer 2008

Pediatric Epileptologist Drawn to Most Difficult Cases

Joseph Sullivan, M.D., director of the UCSF Pediatric Epilepsy Center, came to UCSF from the Children's Hospital of Philadelphia (CHOP) in 2007. "There is a huge need for pediatric epilepsy specialists across the country, including in Northern California," he explains. "UCSF has all of the fundamental pieces in place to provide the state-of-the-art care that these children require and I saw this as a perfect opportunity to build a comprehensive center to better serve children with epilepsy in Northern California."

A pediatric neurologist by training, he admits that he originally wanted to be a pediatric neurosurgeon. "I had a mentor in medical school who was a pediatric neurologist and I became fascinated with that field," he says. "Of course, as I learned more about pediatric epilepsy, I found myself coming back full circle to my interest in neurosurgery, as I now work very closely with the neurosurgeons when they are performing epilepsy surgery at the center."

A graduate of Albany School of Medicine, Sullivan completed his residency at Children's Memorial Hospital at Northwestern University and spent an additional year there as chief resident. He completed his child neurology, clinical neurophysiology and epilepsy training at CHOP. Sullivan worked as a pediatric neurologist and researcher for two years at CHOP, where he specialized in evaluating and treating children with epilepsy—especially those with refractory epilepsy that won't respond to medications.

His primary area of research has been in the use of functional magnetic resonance imaging (fMRI) to identify areas in the brain that control language in children with epilepsy. Since 2005, he has been participating in a study using fMRI to localize language, which is being carried out by a consortium of 13 research centers across the United States, Canada and Australia.

"We don't always know where language is located in the developing brain," Sullivan says. "The concept of cerebral plasticity [the ability to adapt in a way that an adult's brain cannot] is one of the most exciting aspects of pediatric neurology, but it raises risks during neurosurgery. With fMRI, we can detect subtle changes in blood flow in the brain while the child is answering true-false questions or listening to a story and responding to questions about it. That allows us to see what specific areas are involved in language tasks and to make more informed decisions about surgery for that child."

Sullivan has a particular interest in children with intractable epilepsy. "We don't yet know the full effects of seizures on the developing brain," he says. "But it seems clear that the earlier we intervene, the better the outcome we're likely to have with regard to overall development of both cognitive skills and motor control."

For more information, contact Geraldine Dalida at (415) 353-8164.

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