The Child Neurology Society has chosen Leon G. Epstein, MD as the 2022 Hower Award recipient for his contributions to the CNS and his achievements as an accomplished academic neuroscientist, gifted educator, master clinician, and forward-thinking neuroethicist. Dr. Epstein is the ideal choice for this award as he serves as a role model for child neurologists and trainees worldwide.
Dr. Epstein was born in the Bronx and grew up in a working-class neighborhood before moving to Levittown on Long Island, New York. After graduating high school, he traveled to Michigan where he intended to major in aerospace engineering at the University of Michigan. However, due to his insatiable curiosity, his studies took him on a journey through philosophy, politics, and eventually to medicine. He graduated from Detroit’s Wayne State University School of Medicine in 1973 and subsequently completed an internship in pediatrics at St. Joseph’s Mercy Hospital, University of Michigan. He ventured to the University of Arizona for his residency in Neurology and then back to New York in 1976 for his fellowship in Child Neurology at Columbia Presbyterian Medical Center under the mentorship of Sidney Carter.
Dr. Epstein’s first faculty appointment was as an assistant professor of Pediatrics and Neurology at the State University of New York at Stony Brook in 1978. Two years later, he transitioned to the University of Medicine and Dentistry of New Jersey (UMDMJ) to join Richard Koenigsberger and became an Associate Professor and Director of the Neurology Clinic at Children’s Hospital of New Jersey. During this time, Dr. Epstein cultivated his interest in neurovirology with a particular interest in the neurologic manifestations of HIV in children. He reported the first series of children with AIDS in the United States. These children were born to HIV-infected mothers and had neurologic manifestations including a progressive encephalopathy.
To further his skill set and address the pathogenesis of HIV in the nervous system, Dr. Epstein spent time in the 1980s as a visiting scientist at the National Institute of Neurological Disorders and Stroke (NINDS) in Carleton Gajdusek’s Laboratory for Central Nervous System Studies, and in the University of Amsterdam’s Human Retrovirus Laboratory. Dr. Epstein’s ensuing work included seminal papers on the pathophysiology of HIV infection in the brain. He conducted groundbreaking studies that identified HIV-1 infection of macrophages/microglia in the brain and demonstrated that brain inflammatory pathways were important in causing HIV-induced brain injury. He also served as a consultant to the CDC, surgeon general, and WHO regarding HIV in children.
In 1989, Dr. Epstein left New Jersey for the University of Rochester School of Medicine where he continued his HIV-focused neurovirology work as the Director of the Laboratory of Molecular Neurovirology. His work has been NIH-funded since 1986. He was the Principal Investigator of several multi-center studies evaluating cognitive impairment in HIV infected individuals, including the Northeastern AIDS Dementia study and a project using quantitative MRI to develop neuroimaging biomarkers of HIV-related cognitive decline. Dr. Epstein has led several clinical trials aimed at treating HIV-associated cognitive decline. To further these efforts, he received a Fulbright scholarship and spent a year in Chester Beatty’s laboratory at the Institute for Cancer Research at the University of London.
Dr. Epstein’s research has also demonstrated the impact of viral infections, and Human Herpesvirus-6 (HHV-6) in particular, for their role in causing febrile seizures in young children. He was a co-investigator in the large prospective Consequences of Prolonged Febrile Seizures in Childhood (FEBSTAT) study, which determined that infections with either HHV-6 or -7 account for one-third of cases of febrile status epilepticus.
In 1999, Dr. Epstein left the University of Rochester to become the Division Head of Neurology at the Ann and Robert H. Lurie Children’s Hospital of Chicago. He is currently the Derry A. and Donald L. Shoemaker Professor of Pediatrics and Neurology at the Northwestern University Feinberg School of Medicine. He has served in a variety of leadership roles, including Associated Program Director for the Northwestern University General Clinical Research Center and Medical Director for the Clinical Research Unit, a part of the Northwestern University Clinical and Translational Science Institute. He is beloved by his faculty and scores of trainees. His trainees claim that he is the most approachable department chair in the country and appreciate his participation in educational conferences, sharing countless teaching pearls (even if his discussion points are long-winded).
Dr. Epstein has a longstanding interest in biomedical ethics. He chaired the Child Neurology Society Ethics Committee and has been a member, for more than a decade, of the Ethics, Law, and Humanities Committee (ELHC), a combined committee of the American Academy of Neurology (AAN), the American Neurological Association (ANA) and the CNS, serving as Chair since 2019. In this role, he has co-authored AAN position statements concerning ethical issues including neuroenhancement, brain death, clinical research, physician-assisted death, drug pricing, social media, health disparities, and racial justice. During the sometimes tense deliberations to construct these position statements, he is a keen listener, sensitive to the perspectives of all stakeholders, and a masterful facilitator of often opposing opinions. He leads by example and creates an environment where people respect one another. He is kind and patient, always willing to seek out the good in people and give them the benefit of the doubt.
On a personal level, he has been married for over 40 years to Jane Holl, MD MPH, a pediatrician and health services researcher; they have three adult sons. Dr. Epstein has endless curiosity. He loves to ask questions and generate excitement and curiosity in others. His curiosity extends beyond his clinical work and is evidenced by how he enriches his life by hiking in and climbing alpine mountains and building and playing acoustic guitars.
Dr. Epstein is devoted to his patients, colleagues, students, and our larger community. He has a strong social conscience and works tirelessly as an advocate for neurologic health, especially for children with disabilities and chronic neurologic illness. His academic accomplishments, leadership skills, teaching, and clinical skills set the bar high for those of us who follow in his path.