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Frederick Andermann, MD

Frederick Andermann, MD

Frederick Andermann was awarded the Bachelor of Science by McGill University in 1952 and his M.D., magna cum laude by Université de Montreal in 1957. His year of Rotating Internship was completed at the Hôtel Dieu De Montreal, Hôpital Notre- Dame, Hôpital de la Misericorde, and Hôpital Pasteur in Montreal. His 41/2 years of Residency at the Montreal Neurological Hospital, Montreal General Hospital, and Queen Mary Veterans Hospital included Medicine, Neurology, Child Neurology, Psychiatry, Neuropathology, and Electrophysiology.

Andermann’s developing interest in neurology was influenced by Dr. Jean Saucerie (who had trained in Paris with Charcot’s pupil, d’Alembert) and Francis McNaughton, Chief of Neurological Services. McNaughton’s “gentleness and legendary kindness” impressed Andermann, as well as the fact that he was “the neurologist’s neurologist.” Perhaps his greatest formative influence was Preston Robb at Montreal Children’s, a towering figure who was at that time at the height of his power. His fondness for children, powers of observation, phenomenal clinical judgment and decisiveness impressed Andermann.

The deeply thoughtful and analytical Pierre Gloor was his mentor in electroencephalography. Many of the same qualities found in these mentors found fertile ground in Andermann, notably a passion for teaching, a desire to manifest “rectitude and fairness” in those he taught, and the commitment to “nurturing independent thought and supporting initiative” that he so admired in Robb.

During residency Dr. Andermann published his first papers, including several on movement disorders in multiple sclerosis, the first of many subsequent papers on unusual movement disorders. In 1961, he published a paper with Gloor on continuous partial inflammatory epilepsy, prefiguring what would become the major concentration of his career. Robb wished to offer Andermann a faculty position, asking him if he would be able to accept the only available one, seeing children. It was thus that Andermann was appointed at Montreal Children’s, where Robb himself provided most of his own consultations. When Robb moved to the National Institutes of Health to join Richard Masland and others in fashioning the modern comprehensive approach to basic and clinical research and training in epilepsy, he turned his own patients over to Andermann.

In 1965 Andermann married geneticist Dr. Eva Andermann, a collaboration that proved highly successful in both their private and professional lives. That same year, Preston Robb returned to Children’s and, five years later, succeeded McNaughton as neurologist-in chief at the MNI, taking prized Andermann colleagues, Marie Joubert and Tony Griegson with him. In 1971 Andermann joined them. Over the ensuing decades, he would see ever increasing numbers of patients with epilepsy of all ages, yet somehow managed to maintain an interest in many other areas of neurology, particularly those that had a clinical overlap with epilepsy, such as migraine and movement disorders.

How does one summarize a publication record that now includes participation in nearly 500 original papers, reviews, chapters, and letters? To some extent this massive outpouring is a testimonial to the collaborative approach taken by one of the world’s largest collections of remarkable physicians within the context of the Montreal Neurologic Institute. Yet even within that Penfieldian fellowship, this record of publication is extraordinary. Thus Dr. Andermann’s capacity on the one hand to support and on the other to originate and organize investigations must have played a considerable role – as have similar capacities on the part of his wife. Robb, who in common with most neurologists of his day knew little of the genetic aspects of epilepsy, found it difficult to answer questions posed by parents of children with epilepsy on that subject. Likely for that reason, he supported the development of genetic studies of epilepsy, including on his staff Julius and Kay Metrakos, as well as Eva Andermann.

The quality of the publications coauthored by Dr. Andermann is reflected in their record of citation: 200 (40%) have been cited more than 20 times, an exceptionally high number. When one considers that 105 have been cited more than 50 times and 45 have been cited more than 100 times, the status of this body must be estimated as truly and thoroughly first-rate. The most highly cited paper is Pierre Gloor’s famous 1982 experimental formulation of the role of the limbic system in temporal lobe epilepsy (457).

Among the remaining papers with 100+ citations – and in most cases lengthy lists of distinguished coauthors – Andermann is first, second, or corresponding author of more than half. As important, there is a clear pattern in these papers of retaining pride of place for exceptionally talented trainees and junior colleagues. This may be an admirable MNI trait. In Dr. Andermann’s case, it is as well a reflection of the capacity he shared with Robb to attract bright minds and provide them with opportunities, ideas, and support that produce such first class results and remarkable subsequent academic careers.

The scope of Dr. Andermann’s papers and chapters beggars description. Fully 70% consider epilepsy, leaving “only”150 treating other subjects. Throughout this vast corpus of work the approach is comprehensive, considering evaluation, drug and surgical treatment, classification, imaging, pathogenesis. Of great importance are the papers that consider diagnostic dilemmas and quality of life in epilepsy. A career’s worth of papers are found on other individual topics, particularly complex genetic diseases, with more than twenty papers describing novel conditions and many more skillfully refining the semiology and classification of known conditions. Movement disorders and ataxias are richly represented, particularly alternating hemiplegia and hyperekplexias. Many long term followup results are reported, some intervals that may exceed 40 years. His efforts to refine classification show Andermann as the embodiment of his mentor, Robb, and his close friend, Fred Dreifuss. When Dreifuss finally relinquished the chair of the classification committee of the ILAE after his lengthy and remarkable service, he was particularly satisfied that his successor was to be Fred Andermann.

Dr. Andermann has long held the position of Chief of the Epilepsy Service and Clinic, Associate Electroencephalographer at the MNI. He holds Consultant appointments at a long list of Canadian Hospitals. He is past President of the Canadian Neurological Society; the Canadian League Against Epilepsy; the Canadian Society of EEF, EMG, and Clinical Neurophysiology; the Eastern Association of Electroencephalographers; the Association des Neurologues et des Neuropsychiatres de la Provence du Quebec; the Board of Examiners in Neurology, Quebec; the Canadian Association for Child Neurology; and has held many other Directorships, Liaison or Advisory positions. He is currently 1st Vice President of the International League Against Epilepsy. He has served as member of the Editorial Boards of seven major journals.

Dr. Andermann’s major honors include the Epilepsy Research Award of the AES and Milken Family Foundation (1999; the William G. Lennox Award of the AES, the Prix du Quebec – Wilder Penfield Award (2003); the Ross Award, Canadian Pediatric Society (2004); the Order of Canada (2006); the Peter Emil Becker Prize (2007); Honorary Membership, Polish Epilepsy Society (2003); and Corresponding Membership, Swiss Epilepsy Society (2005). The list of lesser honors is far too long to consider here.

It is difficult to know how to summarize a career so exceptional, so utterly phenomenal for its productivity as that of Fred Andermann. He attributes much of this to his associates, particularly his wife Eva, who has co-authored so many of the papers. Dr. Andermann’s success must be due in considerable degree to the combination of intellectual brilliance, insight, sensitivity, limitless curiosity, and the capacity to work hard and work well together with others. In his natural and effective approach to children and adults of all ages with disabilities, Dr. Andermann resembles his mentor, Preston Robb. Both manifested similar fondness for children, unfailing courtesy, understanding, and devotion to care. Although both learned their child neurology “on the fly” as Robb put it, their grasp of our complex field became very early in their careers remarkable not only in scope, but also in depth.

The opportunity to see a master neurologist at work presenting a patient with neurologic disease is the greatest educational experience in which other physicians may participate. The list of the greatest of these is not long, if one is to consider those who have the stature of Gowers, Symonds, Adams, or others. Canada has been greatly enriched with them – Osler, Fisher and others. This is company in which Fred Andermann belongs. Dr. Andermann is quite exceptional with regard to his intrinsic sensitivity to both the cultural and emotional attributes of their patients. He is aided in this by his mastery of a number of languages, a capacity he shares with his old friend, Fred Dreifuss. Andermann’s clinical presentations provide the most memorable picture of disease, personalized to capture as well impact on patient and family, followed inevitably by reflections on what remains to be done to improve recognition, understanding, and treatment. This is not the sort of presentation that can be captured in a “sound-bite” and once in the midst of a presentation Dr. Andermann cannot be deterred from completing the orderly sequence of observation and reflection, with not a word too few or too many. The same is true of his similarly eloquent papers and scientific presentations. Preston Robb’s own view of Fred Andermann highlighted his boundless energy, loyalty, and his capacity to stimulate research in congenital malformations and heredofamilial degenerative diseases. Dr. Robb similarly praised the achievements of Eva Andermann, including her work on the effects of anticonvulsants on fetal development. Together, the Andermanns have shared a long and exceptionally productive life. It has been enriched not only by medicine and science, but by three accomplished children and a wide circle of devoted friends and associates. Fred Andermann has demonstrated the knack of getting to know and being attentive to not only fellow physicians, but their spouses as well. The Andermanns share an interest in the outdoors, particularly plants, birds, and the raising of Norwegian ponies on their farm near the Vermont