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Preface to the special issue on epilepsy therapies dedicated to Dr. Raman Sankar

2018; Wiley; Volume: 3; Issue: S2 Linguagem: Inglês

10.1002/epi4.12279

2470-9239

Andréy Mazarati, Solomon L. Moshé,

Neuroscience and Neuropharmacology Research

We are delighted to introduce this Special issue of Epilepsia Open on epilepsy therapies, dedicated to our colleague and friend, Professor Raman Sankar (commonly known as simply Sankar) (Fig. 1). Sankar's path to medicine and biomedical research has been all but traditional. His career started with chemistry, upon receiving bachelor of science degrees in chemistry in and chemical technology from the University of Bombay. This was followed by a PhD in medicinal chemistry at the University of Washington. It was during his tenure as a faculty member of the medicinal chemistry department at Xavier University, when his long and, as it turned, unending love affair with neurology started. A brilliant chemist in his own right, he was attracted by the elegance and rationality of chemistry and pharmacology of antiepileptic drugs. This ultimately defined his entrance into the neurology field. What was chemistry's loss became medicine's gain. It would be only appropriate to invoke a line from his favorite rock band the Grateful Dead, “What a long strange trip it's been.” We would be remiss, of course, not to mention the role of his mentors, Alain Huitric, Floyd Domer, Donald Shields, Claude Wasterlain and Pete Engel, in shaping Sankar as a scientist and a physician. Sankar's contribution to biomedical research is diverse and profound. Beginning with his 1995 paper in American Journal of Neuroradiology, which was first to describe the evolving of magnetic resonance imaging signal changes with development due to a fixed defect—cortical dysplasia—and the impact of understanding these changes on the selection of infants for epilepsy surgery. Including his input in establishing and understanding mechanisms of neuronal cell death in the immature brain (a rather controversial topic at that time) and concluding with his most recent interest in neurobehavioral comorbidities of epilepsy, Sankar's work reflects his stature in basic and clinical epileptology. It is well deserved that he has been recognized this year by the Founders Award of the American Epilepsy Society. With all his achievements, Sankar remains a unique blend of a chemist and a physician. Observing him drawing chemical formulas and pathways on the whiteboard next to his office, induces nothing but awe in postdocs, residents, and peers alike. This contagious excitement radiating from Sankar every time he talks about science, makes him also an outstanding teacher and mentor to numerous fellows, residents, postdocs, and graduate students, attracting the future of neurology and neurobiology. The formal side of Sankar's activities is easily found on the internet. He has over 250 original papers, critical reviews, and book chapters and is a most highly sought speaker at scientific meetings, conferences, grand rounds, and advisory boards around the world. His tireless fundraising efforts for, and personal generous contributions to, the epilepsy cause are well known. A more intimate side is his interest in and knowledge of music, architecture, film, aviation, and cuisine, which completes a picture of a true Renaissance man. A person who deserves a special mention is Oonagh, a brilliant professional, and also Sankar's patient and loving wife. It would be difficult to overstate her role in Sankar's life and career. Given Sankar's background, it is not a coincidence that this issue is dedicated to epilepsy therapies. We attempted to bring together Sankar's close friends, both colleagues and mentees, to contribute to this eclectic collection of articles—opinions, critical reviews, and original findings—which cover wide-ranging topics revolving around the treatment of epilepsy. The enthusiasm with which they responded was overwhelming, and we are thankful to them for taking time to become a party to this venture. Of note, even though the authors were invited, all articles were subjected to rigorous peer review in order to be accepted. We also wish to thank the Editors-in-Chief for the opportunity to serve as Guest Editors for this issue. We hope that our effort has succeeded not only to highlight the present state of the subject matter, but also to inspire young clinicians and basic scientists alike for further endeavors. Enjoy. Solomon L. Moshé, MD and Andréy Mazarati, MD, PhD Guest Editors. My name is Samantha Wooden and I have epilepsy. I am 25-years-old. I have a job, a driver's license, and I am able to take care of myself as long as I take my medications. My life would have been entirely different if I had never met Dr. Raman Sankar. I started having grand mal seizures when I was 15-years-old. One day, when I returned home after school, I had my first seizure; from then on, seizures were re-occurring and getting worse. As the seizure frequency was increasing, my doctor suggested seeking help at pediatric neurology at UCLA. Around that time, my sister was diagnosed with absence seizures, and both she and I were referred to a UCLA Child Neurologist—Dr. Sankar. I recall our first encounter with some regret, as I was very rude to him. I was a 15-year-old girl, whose life had dramatically changed. I was angry, confused, and uncertain about what this all meant to the rest of my life, and I wondered why this was happening to me. Dr. Sankar walked into the room with a big smile and greeted each of us—my mom, my sister and me. He was very different from other doctors whom we had seen; they used many medical terms that we could not understand, rushed through the appointments, and remained very distant. Dr. Sankar, on the other hand, was very kind and took all his time to answer all our questions. Afterwards, I felt guilty for being disrespectful to him during our first meeting. Unfortunately, during our 11-year relationship, that was not the only time when I behaved angrily; despite that, Dr. Sankar always remained calm, kind, and attentive. After my first appointment, Dr. Sankar saw me frequently. I was one of those patients, who, one might think, finally found the right medication at the right dose, but then another seizure would happen, and we would go back to the drawing board. After 2-3 years, I began feeling that nothing would ever work, and that seizures would never stop. I grew to accept a horrible fact: that I would never be normal and that I would always fear that another episode might occur at any moment. But even when I was feeling desperate and low, Dr. Sankar kept trying to figuring out how to help me, so that I could have normal life. Over the years, we grew close; he saw me breaking down and crying out of frustration. He told me about his colleague whose wife had epilepsy. Dr. Sankar showed me a picture of their children, and when I asked if I would be able to have children one day, he reassured me in a very positive and confident way. One remarkable quality of Dr. Sankar is that he treats his patents as if they were his family. He gave me his personal phone number; this came in handy once, when my VNS device malfunctioned. A couple of months after I got a VNS device, I had 2 seizures not far apart from one another, and I ended up in the emergency room (ER). The ER doctor said that turning the device off required seeing my neurologist. I called Dr. Sankar, and even though it was Friday night he attended to me. Not sure if a regular doctor would have ever done that; but Dr. Sankar is anything but a regular doctor. My case was very difficult, and it took 5 long years trying different medications, different doses, and a surgery, to finally get control of seizures. I am blessed that I met Dr. Sankar, and that he never gave up, even when I was ready to give up on myself. Dr. Sankar is my doctor, but he is more than that, he is family. I am sure that I am not the only of his patient who feels this way. Samantha Wooden. The authors declare no conflicts of interest. We confirm that we have read the Journal's position on issues involved in ethical publication and affirm that this report is consistent with those guidelines. Andréy Mazarati, MD, PhD, Professor, Department of Pediatrics, UCLA School of Medicine. Solomon L. Moshé, MD, Professor, Departments of Neurology, and Neuroscience, Albert Einstein College Medicine.