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Abe Chutorian, MD

Profile written by LEONARDO GARCIA, MD

Abe Chutorian, MD
Abe Chutorian, MD

Dr. Abe Chutorian, then a Canadian citizen, received his M.D. degree from the University of Manitoba in 1957. Following a year of internship at the University’s teaching hospital, he received his training in pediatrics at the University of Southern California’s Children’s Hospital in Los Angeles. Dr. Chutorian was subsequently awarded a National Institute of Health fellowship for three years. He was then recruited by Dr. Sidney Carter at Columbia University’s Neurological Institute of New York to the pediatric neurology fellowship program. At the completion of his fellowship in 1963, he was invited to join the attending staff at the Neurological Institute where, from 1963 to 1990, he spent a notable career in teaching, patient care, and clinical research, along with distinguished colleagues Drs. Arnold Gold, Niels Low, James Hammill, M. Richard Koenigsberger, and others. Graduates of that program (too numerous to name) went on to distinguish themselves as leaders in their specialty.

Dr. Chutorian was considered a gifted clinician-teacher, and over the course of his career published 146 papers, chapters in textbooks, and abstracts, making annual

presentations at scientific meetings of the American Academy of Neurology, the American Neurological Association, the Child Neurology Society, the lbero- American Pediatric Neurological Society, and other national and international forums. At a ceremonial dinner honoring his nearly 30 years of service at the Neurological Institute of New York, Dr. Sidney Carter remarked particularly on Dr. Chutorian’s analytical skills, and the focus and clarity of his presentations and lectures, not least on his penchant to recognize and uncover novel clinical disorders and phenomena. In recognition of these qualities, Dr. Chutorian was invited by the American Academy of Neurology to head the section of pediatric neurology for the purpose of organizing and presenting the annual pediatric neurology lectures at the scientific meetings of the society, from the late 1960’s to the early 1970’s.

Dr. Chutorian left Columbia in 1990 when Dr. Fred Plum recruited him to become the Director of Pediatric Neurology at Cornell Medical College and the New York Hospital. He was appointed Professor of Neurology and Pediatrics at that institution, a post which he held from 1990 to 2005. Together with Dr. Gail Solomon and Dr. Hart Peterson, additional staff was recruited and an active and productive clinical care,
teaching, fellowship, and clinical research program ensued. During those years, Dr. Chutorian was also appointed Director of Neurology at the Hospital for Special Surgery, a post he held for the next eight years. He remained Director of Pediatric Neurology at that institution until 2005. At this premier orthopedic hospital, he directed a neuromuscular clinic, held regular conferences, taught orthopedic, pediatric and pediatric neurology trainees the medical and pre- and post- surgical management of children with central and peripheral neuromuscular disorders, including cerebral palsy, skeletal malformations, scoliosis, and neuromuscular disorders.In 1994, Dr. Chutorian authored a pioneering clinical research publication on the treatment of spasticity of children with botulism toxin. Since 2005, Dr. Chutorian has maintained his appointment at Cornell, and returned to Columbia as Professor of Clinical Neurology, where he participated in the teaching program and conferences.

Dr. Chutorian’s clinical interests have been wide ranging, but include focused areas of interest. While his publications range anatomically from the central to the peripheral nervous system, and clinically from structural to metabolic disease, he has made multiple notable contributions to the literature on optic nerve and retinal disorders, auto- immune disorders, movement disorders, metabolic disease, and intracranial and spinal cord tumors.

Dr. Chutorian’s reports of novel clinical and clinico-pathological entities include:

  • A report of a new syndrome of benign familial chorea with
    intention tremor (1966).
  • A syndrome of opsoclonus-myoclonus in association with
    neuroblastoma as a distinct clinical pathologic entity, and attribution of the disorder to auto-immunity, since then amply documented (1968).
  • A novel post-infective generalized chorea with after-going Parkinsonism due to influenza-A, documented by sequential viral titers, and demonstration that the hyperkinesia was caused by hypersensitivity to circulating L-Dopa, documented by sequential changes in the quantity of this metabolite in the cerebrospinal fluid (1976).
  • A new X-linked disorder manifest in progressive optico- acoustic degeneration and polyneuropathy (1967). Dr. Chutorian’s co-author was Dr. Roger Rosenberg, then a neurology rotating resident on Dr. Chutorian’s teaching service. Dr. Rosenberg attributes his subsequent interest in a career in neurological genetic disorders to his experience of this early encounter. Subsequently the molecular genetics and spectrum of the disorder have been amply established.
  • A juvenile variant hexosaminidase deficiency and a separate hexosaminidase compound with a juvenile gangliosydosis phenotype (1977 and 1980)
  • An extensive study of a novel neurotoxic movement disorder, juvenile Parkinsonism due to cytosine arabinoside, with demonstration of cerebrospinal fluid metabolites, PET, and MRI clinically correlated alterations, and clinical responsiveness to L-Dopa replacement (2003).
  • A clinical syndrome in children consisting of benign paroxysmal torticollis, tortipelvis and retrocollis (1974).
  • A report on the association of Bells Palsy with benign intracranial hypertension in several children (1977).
  • A clinical pathologic syndrome mimicking polymyoclonia, with unique microscopic changes in the brain, and characterized clinically by juvenile global tremor (2007).

Among the novel clinical phenomena reported by Dr. Chutorian are:

  • The earliest indication that transcarbamylase deficiency is
    X-linked and largely lethal in males but manageable in
    females (1970).
  • The occurrence of isolated pallanesthesia and ataxia in
    chronic infantile polyneuropathy (1975).
  • Quantitative demonstration of an inverse relationship between
    cerebrospinal fluid pressure and corticosteroid dosage in
    children with refractory pseudotumor cerebri (1975).
  • The demonstration that megalencephaly in cerebral gigantism (Sotos syndrome) is due to impaired cerebrospinal fluid reabsorption at the arachnoidal villi, demonstrated by delayed clearance of isotope at that level (1988).
  • Demonstration that recurrent brainstem compression masquerades as electro-decremental seizures (1991).

Following are comments by distinguished colleagues, some of whom were former fellows.

  • Dr. Douglas Nordli: Dr. Chutorian is a gifted teacher and he has influenced generations of child neurologists with his extraordinary skills.
  • Dr. Leon Epstein: Among my mentors, Dr. Chutorian stood out in several important respects. He was by far the most impressive critical thinker I have met to this day. He had an uncanny ability to see novel clinical syndromes and he could determine precisely what was, and was not relevant. His papers are a joy to read. Although most fellows were initially intimidated by his intellect, almost all in the end found him to be a warm and compassionate physician and a friend with a great sense of humor.
  • Dr. Kenneth Swaiman: His teaching abilities, writings, and incomparable clinical skills distinguish him as a unique pediatric neurologist and leader of the discipline.
  • Dr. Darryl De Vivo: Dr. Chutorian has had a distinguished academic career as a clinician and educator, and I can think of few people who are more deserving than he for this recognition. Dr. Chutorian was part of the modern beginning of child neurology in the United States, and his contributions remain relevant to the present day.
  • Dr. David Rothner: Dr. Chutorian’s skills in the area of patient care were recognized early in his career. Obtaining data crucial to the diagnosis and his manner of performing the neurological examination were legendary. His ability to collate these facts into a clear, concise coherent differential diagnosis and plan of evaluation and treatment put him into a category all his own.
  • Dr Michael Painter: Abe Chutorian is universally admired by child neurologists he has trained and colleagues with whom he has interacted. His commitment to education was unsurpassed, and his demand for evidenced based decisions fostered the development of critical thinking, not only in students and residents, but colleagues as well.
  • Dr. Pat Crumrine: Dr. Chutorian is the quintessential child neurologist. He engaged medical students, child neurology and adult neurology residents, challenging them to think “outside of the box” and involved them in projects leading
    to publications in peer reviewed journals and to academic careers. He has the ability to obtain the pertinent clinical information, perform the neurological exam and develop a concise differential diagnosis in a short period of time; he was a master at this and his trainees worked to emulate these skills. As valuable as he was as an educator and mentor, he and his wife Helen played an equally important role in the lives of his trainees. They hosted lively dinners at their home for the trainees and their significant others, making certain that the residents were having a social life as well as an academic one.

For 65 years Dr. Chutorian and his wife, Helen, a retired social worker, have been devoted to each other, to their three daughters and their spouses, 10 grandchildren, and three great-grandchildren.