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Kalpathy Krishnamoorthy, MD

Profile written by Robert S. Rust, MD, MA

Professor Kalpathy Krishnamoorthy was born in Secunerabad, India. His collegiate and professional degrees were all earned in India: undergraduate from the P.S.G Arts College (1956), premedical from St. Joseph’s College (1957), M.B.B.S.in Medicine from the Madras Medical College (1964), and an ensuing Postgraduate Medical Diploma (D.C.H.) from the Bombay College of Physicians (1966). Training in pediatrics occurred in several distinguished programs in India (completed as Chief Resident). His interest in pursuing a career in child neurology was made on the basis of the interest and concern that arose as he saw children with neurological diseases. One individual in Bombay, Professor S. M. Merchant, was responsible for arousing this interest. In Dr. Krishnamoorthy’s words, “Professor Merchant laid the foundation to my career.” It is likely that that individual had something to do with planting the seeds that were to result in Dr. Krishnamoorthy’s career-long devotion to the processes of medical student and house staff education. Two years of pediatrics residency in the United States was arranged, followed by three years of training as a neurology resident at the Massachusetts General Hospital/Harvard Medical School. It was during his neurology training that Dr. Krishnamorthy’s exposure to neurological management of neonates confirmed the further direction his career would take.

Dr. Krishnamoorthy’s fascination with the neonatal diseases was greatly enriched by several role models, particularly Ray Adams and Robert DeLong. Keen interest in neuroscience also arose because of the examples provided not only by Adams and DeLong, but also by Alan Leviton. Robert DeLong was the person who initially aroused what would be a particular career-long focus of Dr. Krishnamoorthy’s: the then rather incompletely understood phenomenon of neonatal brain hemorrhage. His fascination with a problem that was then poorly understood in almost any meaningful way (cause, evolution, and treatment in particular) inspired significant advances in neurological understanding, prevention, and treatment in this area.

Dr. Krishnamoorthy’s exceptional abilities were well-recognized at Harvard. Upon completion of his neurology residency, he was appointed Instructor in Pediatrics and Neurology, with ensuing advancement to Professorship in Pediatrics and Neurology at Harvard in 2003. New role models emerged at MGH, including Daniel Shannon, David Todres, Verne Caviness, and Karl Kuban. Dr. Krishnamoorthy’s interest in neuroradiology was roused by Ellen Grant. She demonstrated the manner in which advancements in imaging technology would provide many opportunities to explain and understand the neurological diseases of the infants Dr. Krishnamoorthy encountered.

Other persistent interests that arose early in Dr. Krishnamoorthy’s career were inspired and cultivated by superb role models, including epileptologists Greg Holmes and Mohamad Mikati, and metabolic disease experts Vivian Shih, Harvey Levy, and Marvin Natowicz. Additional exceptional mentors cultivated persistent professional interest in other areas of neurology and neuroscience that have retained Dr. Krishnamoorthy’s clinical and scientific efforts throughout his career: Peter Rosenberger joined Professor DeLong as a mentor and role model for the behavioral aspects of neurology; Marvin Natowicz, Aogsli Lin, and Lew Holmes did so for genetics; Leon Dure for movement disorders; Katherine Sims, Ed Kolodny and Marvin Natowicz for degenerative disorders; Keith Chiappa and Kenneth Sarrower served as fine EEG mentors. Carsten Bönnemann was instrumental in shaping Dr. Krishnamoorthy’s understanding of electroencephalography, neuromuscular diseases and muscle electrophysiology.

Dr. Krishnamoorthy has served as a consulting neurologist in the Newborn Intensive Care Unit of the Massachusetts General Hospital for 42 years. He served for 33 years as Director of the NICU Follow-up Program and for 24 years as Co-Director of the MGH Pediatric Neurology Ambulatory Clinic. He was a member of the MGH Intern Selection Committee of the Pediatric Service for 14 years and a member of the Resident Selection Committee for candidates to train in Child Neurology for 40 years. He has been an Evaluator and Advisor to the Resident Education Committee of the MGH for the past 14 years. Dr. Krishnamoorthy served as an examiner for Oral Boards in Child Neurology for 22 years.

Professor Krishnamoorthy has been particularly recognized for the active and intelligent role that he has played as clinical preceptor for both adult and child neurology residents in the MGH clinic and ward services. From 1974-2009 he participated in all ongoing consultations in the NICU and the inpatient services of the MGH. His educational efforts involved both child neurology and pediatric residents.on his service. He participates as well in Brain Cutting Conference and the Neuro-Radiology Teaching Conference and fulfills rotations on the inpatient Pediatric Service. He plays quite a responsible role in teaching Child Neurology to Child Psychiatry Residents. He served as Consultant for the MGH myelodysplasia program from 1976.2000, and to the SIDS program of the MGH from 1976-1985.

The research performed by Dr. Krishnamoorthy and his collaborators has chiefly concentrated on pioneering studies of the neonate, including diagnosis, management, and outcomes of hypoxic-ischemic encephalopathy, intracranial hemorrhage of prematurity, metabolic diseases, and of seizures. One particularly important contribution was made by a collaborative study funded by NINCDS that not only demonstrated the lack of efficacy of this approach for the prevention of intraventricular hemorrhage, but also the tendency of this approach to increase the risk for neonatal ventriculomegaly. Dr. Krishnamoorthy has made important contributions, in collaboration with Dr. Paul Caruso, to fetal neurology. The knowledge that he has gained has been based on evaluation and management of more than 5000 neonates. Dr. Krishnamoorthy has proven a valuable participant in the ELGAN group studies of the neonate, collaborating with and supporting the efforts of Professors Leviton, Kuban, Todres, and Natowicz, along with radiologist, Ellen Grant. The MGH group pioneered the use of CT scans for diagnosis of intraventricular hemorrhage and have published numerous important papers on the developmental outcome of intraventricular hemorrhage.and the clinical factors that determine it, particularly post-hemorrhagic hydrocephalus and parenchymal hemorrhage. Dr. Krishnamoorthy has collaborated with the efforts of this group to better understand neonatal hypoxic-ischemic brain injury and intraventricular hemorrhage, and demonstrating the deleterious effects of the then-in-vogue use of phenobarbital in hopes of reducing the risk of intraventricular hemorrhage. The group also refined the recognition and management of herpes encephalitis, of pyridoxine dependent seizures, and possible prevention of myelin dysmaturity of the neonate. Professor Krishnamoorthy collaborated with and supported the efforts of Professor Kuban and colleagues in placing emphasis on the particular importance of early diagnosis and initiation of management of cerebral palsies. Together with Dr. M. Natowicz, Dr. Krishnamoorthy participated in refinement of neuroradiological labeling and interpretation of imaging findings related to myelin maturation.

Clinical teaching has been an area in which Professor Krishnamoorthy has placed great importance and expended considerable effort. He has played a role in the education of 52 individuals who trained in neurology at the MGH from 1978 to the present and have subsequently held faculty positions at various locations throughout this country and around the world. Dr. Krishnamoorthy has provided 136 invited lectures, either locally or at other medical centers throughout the country. Six CPC exercises for which he was the Invited Discussant have been published in the New England Journal of Medicine. Dr. Krishnamoorthy has made 62 presentations at national meetings. He has published six book chapters and fifteen review papers in journals.

Dr. Krishnamoorthy and his colleagues have published 74 excellent peer-reviewed original papers. He was the first author of 20 of these publications and senior author of nine. The papers are listed below by subject, the number of papers in each topic are indicated parenthetically. They include: Addison disease sciatica (1), Aicardi syndrome (1), Autoimmune nervous system injury (1), Blood volume and oxygen consumption effects on outcome of neonatal brain injury (1), Brachial plexus palsy (1), Brain imaging (7), Cerebral palsy: importance of early diagnosis and management initiation (1), Childhood stroke (2), Delayed myelination of neonates (2), Developmental brain abnormalities (2), Developmental characteristics of the neonate (1), Diffusion-weighted imaging of neonatal brain (1) DiGeorge syndrome vasculopathy (1), Drug toxicities (2), Epilepsy (8), Headache (1), Heritable metabolic diseases (2), Hypoglycoracchia in infantile HSV meningoencephalitis (1), Hypothalamic hamartoma (2), Infantile astrocytoma (1), Infantile myofibromatosis (1), Intracranial hypertension (3), Intraventricular hemorrhage (3), Joubert syndrome (2), Maturation of infants of mothers with myotonic dystrophy (1), Morbidity and mortality in children (1), Muscle-eye-brain disease (1), Neonatal apnea (1), Neonatal brachial plexus palsy (1), Neonatal brain injury – importance of early diagnosis (1), Neonatal catheter-related vasculopathy (1), Neonatal low-grade IVH outcome (2), Neonatal hearing loss (2), Neonatal herpes encephalitis (1), Neonatal hypertonia (1), Neonatal hypoxic-ischemic encephalopathy (2), Neonatal ischemic brain injury (2), Neonatal intraventricular hemorrhage (7) Neonatal near-infrared spectroscopic imaging (3), Neonatal respiratory distress syndrome (1), Neonatal seizures (1), Neonatal SIADH (1), Neonatal stroke (6), Neonatal thrombocytopenia (1), Neuromuscular disease (1), Non-epileptic events (1), Paroxysmal headache with visual changes (1), Phenobarbital intoxication (1), Phenytoin-related choreoathetosis (1), Prader-Willi syndrome (4), Prediction of microcephaly in neonates (1), Pyridoxine dependency seizures (3), SCAD deficiency (1), Sulfite oxidase deficiency (1), Thalamic stroke (1), and Training innovations (1).

Dr. Krishnamoorthy has long served as an ad hoc Reviewer for the New England Journal of Medicine, Pediatrics, Journal Watch Neurology, The Journal of Developmental and Behavioral Pediatrics, Journal of Pediatrics, and for Neuropediatrics. He is an Abstract Reviewer for the Pediatric Academic Society/ Eastern Society for Pediatric Research. Professor Krishnamoorthy has received numerous prestigious awards. The first of these were awarded in India and include Best Performance in Medical Jurisprudence as a 4th year Medical Student (1962); Best Junior Resident Award in Pediatrics, Wadia Hospital for Children, (1965); Student Gold Medal Award. College of Physicians & Surgeons, Bombay (1966); Best Chief Resident Award in Pediatrics, Irwin Hospital New Delhi (1968). During his time on the faculty of the Massachusetts General Hospital, Dr. Krishnamoorthy’s additional awards have included several Teacher of the Year Award, Neurology Service (1993, 2003, 2006, 2010), and the Partners in Excellence Award (2004). This year, fittingly, he is the recipient of the CNS Roger and Mary Brumback Lifetime Achievement Award of the Child Neurology Society.