Meet Dr. Andrew Mower

CHOC Children’s wants its patients and families to get to know its specialists. Today, meet Dr. Andrew Mower, a pediatric neurologist. Dr. Mower attended medical school at St. George’s University School of Medicine, completed a residency in pediatrics at Maimonides Medical Center, and another residency in child neurology State University of New York Downstate. He completed a fellowship in clinical neurophysiology at Columbia University. Dr. Mower sits on CHOC’s quality improvement committee and is part of CHOC’s ancillary and diagnostic services. He has been on staff at CHOC for two years.

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Q: What are your special clinical interests?
A: Epilepsy and epilepsy surgery

Q: What are some new programs or developments within your specialty?
A: Stereotactic EEG for epilepsy surgery

Q: What are your most common diagnoses?
A: Epilepsy and headaches

Q: What would you most like community/referring providers to know about you or your division at CHOC?
A: We take on the most challenging epilepsy cases to search for cures, and, if not, at least an improvement in the child and family’s quality of life. We work together as a team to use all of our expertise to help the child and family.

Q:  What inspires you most about the care being delivered here at CHOC?
A: I feel that we offer families hope when hope had been abandoned before.

Q: Why did you decide to become a doctor?
A: I decided to become a doctor to help people in need. I chose neurology as my specialty because I had a fascination with the nervous system and wanted to break misperceptions that little can be done for patients with neurological problems.

Q: If you weren’t a physician, what would you be and why?
A: Farmer. I love the accomplishment of creating a garden and growing produce.

Q: What are your hobbies/interests outside of work?
A: Gardening, running and hiking

Q: What was the funniest thing a patient told you?
A: “I don’t eat apples, doctor.”

“Why?”

“Because they keep the doctor away, and I like you, Dr. Mower.”

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Test your Brain IQ with this Brain Awareness Week Quiz

At what point does a headache become cause for concern? How rapidly and when does your child’s brain develop? The brain is a complex organ, and sometimes, it produces almost as many questions and it does thoughts (which is about 70,000 per day). To celebrate Brain Awareness Week, take this fun quiz to see how much you know about the brain:

  1. True or False- If kids and teens have headaches, they should automatically be referred to a specialist.
  2. True or False- A newborn’s brain is smaller than an adult’s brain.
  3. True or False- The most active time for brain development is during puberty, when adolescents are rapidly growing and changing.
  4. True or False- The brain is the most complex organ in the human body.
Dr. Mary Zupanc
Dr. Mary Zupanc, CHOC’s neurology division chair, and director of CHOC’s comprehensive epilepsy program.
  1. False- Headaches can occur for a number of reasons and are usually not a sign of a serious medical condition. Before seeking a referral to a neurologist from your pediatrician, first try:
    • Getting enough sleep
    • Drinking plenty of water
    • Eating regular, well-balanced meals
    • Exercising regularly
    • Stress relieving methods such as yoga or meditation
  2. True- At birth, a baby’s brain is one-quarter of the size of their mom or dad’s brain. It will double in size by their first birthday, and eventually weigh three pounds when it’s full grown.
  3. False- The period between birth and two years old is a very active time for brain development. Until puberty, brain development will use up almost half of the body’s daily energy intake. However, brains won’t fully develop until closer to age 25.
  4. True- The brain powers the nervous system, which affects and is affected by all the other systems in your body (cardiovascular, endocrine, gastrointestinal, and immune systems). It has 100 billion neurons- cells known as the gray matter which process information.

Learn more about the CHOC Children’s Neuroscience Institute, where pediatric specialists are providing expert care at the only pediatric neuroscience hospital in the region.

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Preventing and Treating Concussions

CHOC Children’s multidisciplinary team of concussion experts can help prevent and treat concussions, as well as help patients ease back in to school and sports. Careful supervision is essential for young persons with concussions, since their brains are still developing.

In this episode of CHOC Radio, Dr. Sharief Taraman, a pediatric neurologist, Dr. Jonathan Minor, a sports medicine specialist, Jenn Ahlswede, a speech language pathologist, and Mollee Oh, a physical therapist and rehabilitation supervisor, discuss:

  • SCAT3, an assessment tool parents and coaches can use immediately after an incident occurs
  • The film “Concussion,” and how concussions affect kids and teens differently than adults
  • Recommendations for cognizant and physical rest periods after sustaining a concussion

Hear more from CHOC experts in this podcast.

CHOC Radio theme music by Pat Jacobs.

Kara’s Story: A Journey with Epilepsy

Heidi Sexton knew her young epileptic daughter, Kara, needed more help. Anti-seizure medications didn’t help, hospital visits were frequent, and seizures and tantrums continued.

“It was time,” Heidi recalled. “I went in to the next doctor’s appointment with my questions: What else can we try? This isn’t working.”

Dr. Mary Zupanc, director of CHOC Children’s comprehensive epilepsy program, offered her recommendation: Kara needs brain surgery.

A little girl’s long road

Though no doubt a staggering consideration, brain surgery would be the next landmark on a long medical history that belied Kara’s short three years of life.

At just 13 months old, she underwent emergency brain surgery after her frontal lobe hemorrhaged, caused by a previously undiscovered vascular malformation. The hemorrhage in Kara’s brain led to right-side hemiplegia, leaving her no use of her right hand and limited the use her right leg.

Kara underwent physical therapy and began walking at age 2. Life was relatively normal for the Sexton family until just after Kara’s third birthday, when she began acting strangely.

Kara’s body would stiffen, she’d fall down and stare off into space, Heidi recalled. It wasn’t until a visit to the Julia and George Argyros Emergency Department at CHOC Children’s Hospital that the Sextons would learn Kara was having seizures.

At the CHOC Children’s Neuroscience Institute, Kara underwent an electroencephalogram, or EEG, a test that monitors for electrical activity in the brain. Next, she spent six days undergoing long-term video EEG monitoring. From there, Dr. Zupanc, also CHOC’s neurology division chair, made an official diagnosis of epilepsy and prescribed an anti-epileptic medication.

Exploring other options

Nonetheless, Kara’s seizures continued. Kara’s three older siblings were acutely aware of their sister’s disorder, daily counting Kara’s seizures and agonizing over each hospital visit. The family began to placate Kara in hopes of staving off outbursts and tantrums, Heidi said.

“Kara had between two and four seizures a day,” she said. “It really messed with her behaviorally. She’s a lovely kid, but she suffered serious temper tantrums. It was physically and emotionally exhausting.”

A second six-day monitoring session led Dr. Zupanc to change Kara’s medication and, as a precaution, begin evaluating her as a candidate for epilepsy brain surgery.

Further tests and scans revealed that the left hemisphere of Kara’s brain was significantly injured and atrophied – likely related to her earlier hemorrhage. In addition, Kara’s new anti-epileptic medication wasn’t working.

Dr. Zupanc concluded that the next step was a hemispherectomy, a surgical procedure in which one side of the brain is removed or disconnected.

Kara

“On scans, Kara’s hemisphere was completely white,” Heidi said. “The only thing her left hemisphere was doing was causing seizures. There was no question.”

A change of course

Nearly 11 months after the seizures first surfaced, Kara underwent surgery at CHOC to remove a portion of her brain’s left side, and disconnect the remaining portion from the right hemisphere. Performed by neurosurgeon Dr. Joffre Olaya, the procedure lasted six hours.

After 16 days recovering in the hospital’s pediatric intensive care unit, Kara went home just after her fourth birthday.

Much to her parents’ and siblings’ relief, Kara hasn’t had a seizure since her surgery eight months ago. Kara still relies on an anti-epileptic medication, but she may be able to stop taking it completely or use a lower dose of medication soon if her progress continues.

Though considering a second brain surgery was daunting for the Sextons, Heidi and her husband knew the procedure was the right choice to help their daughter.

“I looked at it in a sense of quality of life for Kara,” Heidi said. “Hopefully now she’ll be able to drive one day. Continued seizures would have impaired her cognitively forever, and I didn’t want that.”

Though she still requires extensive care, Kara is doing well physically and emotionally and is looking forward to preschool.

Kara isn’t fully aware of her journey in the last year, but she understands the meaning of the scar on her head just above her ear.

“She knows now that she doesn’t have seizures and Dr. Olaya and Dr. Zupanc fixed her,” Heidi said.

Read other stories about CHOC patients:

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Signs, Myths of Autism Spectrum Disorder

Autism_baby_smallerAutism Spectrum Disorder remains a mysterious but prevalent disorder that now is believed to affect one in 88 children and one in 54 boys in the United States. It’s also the fastest-growing serious developmental disability in the country.

There is no medical detection or cure for autism. However, learning as much as possible about the condition helps families understand and better assist their child with autism, says Dr. Joseph H. Donnelly, a CHOC neurologist and the medical director of The Center for Autism & Neurodevelopmental Disorders.

“The most obvious signs of autism emerge between 12 and 18 months of age,” says Dr. Donnelly.

Here are some signs that may indicate your child is at risk for an autism spectrum disorder:

  • No big smiles or other warm, joyful expressions by 6 months of age or older
  • No back-and-forth sharing of sounds, smiles or other facial expressions by 9 months
  • No babbling by 12 months
  • No back-and-forth gestures such as pointing, showing, reaching or waving by 12 months
  • No words by 16 months
  • No meaningful, two-word phrases (not including imitating or repeating) by 24 months
  • Any loss of speech, babbling or social skills at any age

Parents of children showing these symptoms should ask their pediatrician for an immediate evaluation, advises Dr. Donnelly.

It’s a myth that children with autism lack strengths, says Dr. Donnelly. In fact, people with autism can have significant strengths and sometimes perform better, or are more capable, in certain areas than typical children.

“Never assume a child cannot do something. Try everything and discover a child’s strengths, weaknesses and learning style.” he says. “Children with autism can have learning disabilities like a typical child and this needs to be addressed the same way as with any child.”

Here are some other common myths about autism:

  • All children with autism don’t speak.
  • Children with autism all have an intellectual disability.
  • Autism is an emotional disorder.
  • People with autism don’t exhibit emotions.
  • People with autism can’t lead a meaningful life.

Common medical problems associated with autism include seizures, gastrointestinal problems, allergies and sleep difficulties, Dr. Donnelly says. Autism is often associated with varied behavioral problems like attention deficit hyperactivity disorder, anxiety and obsessive-compulsive disorders.

“Treatment is available.  Seek help from your pediatrician or someone with expertise in autism,” advises Dr. Donnelly.

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