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Harvey Sarnat, MD

Profile written by Robert S Rust, MD, MA

Harvey Sarnat, MD

A Chicago native bearing both American and Canadian citizenship, Harvey Sarnat’s natural interest in science was fostered by neurozoological studies at the University of Illinois, Urbana, earning a Bachelor of Science degree in 1963 and having benefited particularly richly from the strong and formative influence of Zoology Professor Lyell Thomas. Ensuing graduate education at Illinois resulted in a Master of Science degree in 1965 and a Medical Doctorate in 1966. Two years of pediatric residency at Illinois followed. Dr. Sarnat then completed two years of military service as a captain in the U.S. Air Force. In medical school Dr. Sarnat’s attraction to neuroscience had been kindled in particular by the neuroanatomist, Professor LMH Larramendi. As a result, Dr. Sarnat entered and completed in 1973 three years of training in child and adult neurology at the University of Virginia under the rich clinical stewardship of Professor Fritz Dreifuss. His training was further greatly enriched by a year-long fellowship in neuropathology under Ellsworth C. Alvord and Martin G. Netsky. His training as a developmental neuropathologist has benefited greatly as well from guidance provided by Professors Margaret Norman and Miguel Marin-Padilla.

In 1974, together with Professor Netsky, Professor Sarnat was to publish (as first author) a remarkable full length textbook for Oxford University Press concerning the evolution of the nervous system. The work was quickly established as an authoritative account of exceptional quality concerning the comparative neuroanatomy of vertebrate animals, an analysis that was applied with considerable intelligence in order to propose a theory of the probable evolutionary sequence of the vertebrate nervous system. An expanded and extensively revised second edition (nearly twice as lengthy) was published in 1981. Characteristically well-written and intellectually stimulating, the second edition was greatly enriched by the well-organized incorporation and comparative analysis of wide-ranging venerable and quite recent neurochemical and neuroanatomic observations in order to intelligently establish theories of the evolution of neuromuscular control as a critical element in the evolution of species. 

Upon completion of his formal training, Dr.Sarnat entered his academic career as Assistant Professor of Pediatrics and Neurology at St. Louis University (1973-1976). From 1976-1977 he served as Lecturer and Consultant at the University of Western Australia. Associate Professorships in Pediatrics and Neurology were attained at St. Louis University (1977-1978). Associate Professorship in Pathology was added to these titles by the University of Arkansas (1978-1981). He retained that status at the University of University of Calgary 1981-1984) until he was elevated to Professorships (1984-1992). Moving to the University of Washington (1992-2001), he assumed the position of Head, Division of Pediatric Neurology, Professor of Pediatrics and of Neuropathology, and was awarded the Sarkowsky Endowed Professorship in Pediatric Neurology. From 2001-2004 he held Professorships in Neurology and Neuropathology at UCLA. In 2004 he returned to the University of Calgary as Professor of Pediatrics, Pathology, and Neurology until his retirement 2012. Despite retirement, he has greatly benefited Calgary by his commitment to continue to work full-time without salary in research, clinical care, and teaching. 

Throughout his remarkable career as a physician and scientist, Dr. Sarnat has applied his characteristic energy, drive, intelligent organization and wide-ranging educational background to an unusually broad spectrum of research questions. Beginning in 1968, Professor Sarnat has published 174 original peer-reviewed papers based on original research. The subjects are numerous. They include the approach to neurological evaluation (5), cardiac and cardiovascular diseases (2), cerebellar pathology (6), cervical cord atrophy (1), comparative neuroanatomy (2), brain cortical dysplasias (2), other developmental dysplasias (5), developmental neurophysiological science – including approach, lab techniques, comparative perspective, theory, and resulting conclusions (81), endocrinopathies (3), enteropathies (10), environmental science (2), epilepsy pathophysiology/pathogenesis (14), tables of genetic disturbances (9), healing processes in nervous tissues (9), heritable metabolic diseases (8), history of neurology (1), hypoxic-ischemic neural injury (5), and imaging techniques developed or refined (4).

Other subjects studied include inflammatory neural conditions (1), myopathic and neuropathic evolutionary processes and diseases (11), neonatal neurological diseases (3), importance of scientific semantic precision (8), laboratory techniques – especially tissue staining (14), leukodystrophies (3), neurodevelopmental theory (13), neuroembryopathy (8), neuropathic conditions (13), neonatal encephalopathy (8), neoplastic conditions (8), Purkinje cell physiology (3), neurological functional evolution (6), olfaction (2), phylogenetic diseases (1), skull (1), tenotomy (1), synaptogenesis in fetal tissues (10), teratology (1), toxic conditions (2), tumor (2), and vasculopathies (3). Many of the conditions and processes that he and his colleagues have studied relate particularly to fetal and neonatal developmental neuropathology, neurophysiology (in particular epilepsy), immunocytochemistry, and neuroembryology. Professor Sarnat and his group have devoted considerable energy and attention to advancing understanding of the neuroembryological bases of both normal and abnormal brain ontogenesis. He has played particular attention to neuroembryological errors responsible for conditions ranging from the development of epileptogenic neurocortical dysplasias to diseases of muscle. To these original investigations can be added the 108 review papers concerning a wide variety of neurological conditions and scientific methods that he and his group have produced.

Remarkably, he has extended his quite productive attention and reasoning to similarly advancing the understanding of the factors responsible for the development of many other neurological disturbances such as congenital myopathies. In this family of diseases he has been long and quite productively engaged in advancing the anatomic and neuroembryologic understanding of the roles that intermediate filament proteins, trophic factors, and myogenic genes play in the failure of normal peripheral neurodevelopmental processes. The quality of these papers is uniformly excellent, their execution is clearly designed not only to answer questions, but also to entrain the thought processes of the reader in order to refine their approach to the problem considered. A particularly excellent example of what is meant by this is provided by the 1976 paper on the clinical grading of neonatal encephalopathy that he and his colleagues have identified and discussed in original full length scientific papers. His meticulous concentration and desire to instill understanding of neurophysiological processes has resulted in remarkable review papers. These review papers (including five papers that summarize the results of a considerable number of experimental observations) consider adenomatous neural tissue transformation (1), the sources of age-related vulnerability to neurodevelopmental disturbances (6), the developmental theory of cerebral and cerebellar dysplasias (2). His group has considered the histochemical changes of denervated muscle, theoretical aspects of fetal and neonatal muscle maturation, innovations in imaging efficacy (10). Various comparative aspects of the pathophysiology and histochemisry are considered in more than 30 papers.

The first of seven single or co-authored books by Professor Sarnat was published in 1974 considering the evolution of the nervous system. The second edition of this work was published in 1981. In 1983 Professor Sarnat published what became a standard work on muscle pathology and histochemistry. In 1992 Professor Sarnat published the important book Embryology and Clinical Expression. Professor Sarnat served as co-editor of the 6th and 7th editions of Menkes’ Child Neurology. In 2015 he served as Co-Editor for Bluemcke’s Surgical Neuropathology of Focal Epilepsies. To date, Professor Sarnat has published 105 book. 

Dr. Sarnat’s has balanced an extraordinarily high level of involvement in educational activities of North American child neurology with an exceptionally busy round of local, institutional scientific, clinical and administrative obligations. He participated in the first meeting of the Upper Midwest CNS, the first (Ann Arbor) meeting of the CNS, and was an important figure in the celebrated Keystone meeting of the CNS. He has been interested in enhancing the career roles and opportunities available in the United States and Canada to women, minorities, and foreign-born individuals. Understandably, he is keenly and particularly interested in the quality of CNS scientific educational programs. He has played a particularly important role in enhancing the educational success of programs designed to enrich professional understanding of the classification and approaches to treatment of learning and behavioral disorders and of epilepsy.

It is no wonder that Professor Professor Sarnat has delivered 156 invited lectures or visiting professorships throughout the world from 1974 to the present. He has lectured in 31 countries. In Spanish-speaking countries he lectures in fluent Spanish (he was employed professionally at one time as in interpreter). In French-speaking countries he lectures in French. He is an accomplished oboist. Professor Sarnat collaborated with his late first wife, Margaret in 1976 in the establishment of the valuable and well-known Sarnat scale in order to estimate the prognosis for encephalopathic neonates that have experienced stress as the result of given degrees of acute hypoxic-ischemic changes. The analysis employs historical details such as potentially confounding pathological stresses, the presence of seizures, carefully selected results of bedside examination within the first 24-48 hours of life, duration of acute encephalopathy, and electroencephalography in order to establish with considerable success a likely prognostic estimation for a given infant. It is noteworthy that this particular study and paper was included in 2009 by the Neonatal Society of Britain among the 50 most influential papers in neonatology in the preceding 50 years. Among these “most influential papers, the one reporting the Sarnat scale was judge the paper of the fourth greatest importance on the list.

Dr. Sarnat has two children by his first marriage. After his first wife, Margaret, passed away in the mid 1990s, Dr. Sarnat met and married the esteemed child neurologist, Laura Flores; the two have collaborated productively through joint appointments in Los Angeles, Seattle and Calgary. Although he officially “retired” in July, 2013 at the age of 74, Dr. Sarnat has continued to work full-time, chiefly continuing his exceptionally productive neurodevelopmental, neuroanatomical, and neuropathological research programs at Alberta Children’s Hospital.