About

Jennifer McGuire, M.D., M.S.C.E., is an Assistant Professor of Neurology at the Children's Hospital of Philadelphia and an Associate Program Director for the Child Neurology Residency at the same institution. She specializes in pediatric neurology with a focus on infectious diseases of the nervous system, including HIV-associated neurocognitive disorders, viral encephalitis, and neurologic complications of HIV. Her research expertise includes studying HIV-associated neurocognitive disorders in adolescents and the modulation of the host immune system in viral infections within the central nervous system. Dr. McGuire's clinical practice encompasses general child neurology and infectious diseases of the nervous system, with particular attention to neuroimmune dysregulation and neurovirology. She has contributed to the understanding of neuroimmune interactions in HIV-related neurological conditions and has been involved in various research projects and publications related to neurovirology and pediatric neurology.

Research topics

• Medicine
• Intensive care medicine
• Internal medicine
• Pediatrics
• Surgery
• Cardiology

Selected publications

• Delirium in Children Hospitalized with Acute COVID-19 or MIS-C: Secondary Analysis of the 2020–2021 Global Consortium Study of Neurologic Dysfunction in COVID-19

  Neurocritical Care · 2026-04-06

  article
  PublisherDOI

• Motor Function Testing Rates and Outcomes in Duchenne Muscular Dystrophy with Comorbid Autism and ADHD (P2-11.025)

  Neurology · 2025-04-07

  article

  This study examines the populations, treatment differences, and motor outcomes in children with Duchenne muscular dystrophy (DMD) and comorbid autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD).

  PublisherDOI

• Neuroimaging Findings in Children and Young Adults With Neurotoxicity After CAR T-Cell Therapy for B-Cell Malignancies

  Neurology · 2025-09-08 · 7 citations

  articleOpen access1st authorCorresponding

  BACKGROUND AND OBJECTIVES: Neuroimaging findings in immune effector cell-associated neurotoxicity syndrome (ICANS) have not been systematically described. We created the chimeric antigen receptor (CAR) T-cell Neurotoxicity Imaging Virtual Archive Library (CARNIVAL), a centralized imaging database for children and young adults receiving CAR T-cell therapy. Objectives of this study were to (1) characterize neuroimaging findings associated with ICANS and (2) determine whether specific ICANS-related neuroimaging findings are associated with individual neurologic symptoms. METHODS: We performed a multicenter retrospective cohort study of patients ≤30 years who experienced ICANS following CAR T-cell therapy for B-cell malignancies between January 1, 12, and January 31, 23, and had a brain MRI in the first 30 days after CAR T-cell infusion. Deidentified MRIs were reviewed by a central study team of pediatric neuroradiologists with experience in ICANS neuroimaging. Imaging features were categorized and correlated with CAR product and clinical characteristics including preinfusion neurologic history, and postinfusion neurologic symptoms alongside CAR T-cell toxicities using logistic regression. RESULTS: < 0.001). Among 12 patients with ICANS-related MRI abnormalities who had follow-up imaging, 10 of 12 (83%) improved and 3 of 12 fully resolved. DISCUSSION: ICANS-related brain MRI abnormalities demonstrate unique patterns in the cerebral white matter, brainstem and thalami; their prevalence increases with ICANS clinical grade. Because our cohort is enriched for patients with severe ICANS, it likely overestimates the incidence of ICANS-related imaging abnormalities. A better understanding of neuroimaging findings is valuable for parsing pathophysiologic mechanisms of ICANS and optimizing patient outcomes.

  PublisherOA PDFDOI

• Cerebral Sinovenous Thrombosis in Children With Acute Bacterial Intracranial Infection

  Neurology · 2025-09-29 · 3 citations

  articleOpen accessSenior author

  BACKGROUND AND OBJECTIVES: The epidemiology and optimal treatment strategy of cerebral sinovenous thrombosis (CSVT) in children with acute bacterial intracranial infection is largely unknown. We aimed to define the prevalence of CSVT among children with acute bacterial intracranial infection at a tertiary care pediatric hospital, to identify risk factors associated with the development of CSVT in this population, and to describe the use of anticoagulation in these children at our institution. METHODS: This was a retrospective observational cohort study of children aged 1-18 years hospitalized at a tertiary care children's hospital for acute bacterial intracranial infection between January 1, 2015, and March 31, 2023. Children with bacterial meningitis/meningoencephalitis, cerebritis, intraparenchymal abscess, subdural empyema, and/or epidural abscess who had at least 1 head imaging study were included. Cases were identified using ICD codes; medical charts were manually screened to confirm diagnoses. A multivariable logistic regression model was built to identify independent risk factors for the primary outcome of CSVT using the least absolute shrinkage and selection operator technique. RESULTS: Of 108 patients included (median age 10 years, 41% female), 33 (31%) developed CSVT. The prevalence of CSVT did not vary by year, but the absolute number of hospitalizations for acute bacterial intracranial infection rose during the study period, particularly after 2020. Presenting neurologic signs/symptoms did not differ between those who did and did not develop CSVT. Mastoiditis (adjusted odds ratio [aOR] 12.2, 95% CI 3.1-48.5), cerebritis (aOR 4.6, 95% CI 1.5-14.5), extra-axial focal suppurative infection (aOR 10.2, 95% CI 1.7-61.6), and dehydration (aOR 3.9, 95% CI 1.0-15.1) were each independently associated with CSVT. Seventy-three percent of children with CSVT (24/33) received anticoagulation (median duration 91 days) with no major bleeding events. All children with CSVT had at least partial thrombus resolution; 60% (20/33) had complete resolution. DISCUSSION: CSVT is common in children with acute bacterial intracranial infection but difficult to clinically identify. Clinicians should maintain a high index of suspicion for CSVT in this population and consider appropriate screening imaging studies, particularly in children with mastoiditis, cerebritis, extra-axial focal suppurative infection, and/or dehydration. Anticoagulation was well-tolerated in this cohort; further studies should focus on determining its safety, benefit, and ideal duration in infection-related CSVT.

  PublisherOA PDFDOI

• Neurologic and Psychological Outcomes 2 Years After Multisystem Inflammatory Syndrome in Children

  JAMA Network Open · 2025-06-02 · 2 citations

  articleOpen access

  Importance: Neurologic and psychological sequelae are observed 1 year after hospitalization for multisystem inflammatory syndrome in children (MIS-C), but whether these concerns persist is not known. Objective: To examine the trajectory of neurologic, psychological, and quality-of-life sequelae up to 2 years after MIS-C. Design, Setting, and Participants: This longitudinal cohort study assessed children diagnosed with MIS-C from August 1, 2020, to August 31, 2021, and matched sibling and community controls, when available. The study was conducted 6 to 12 months and 18 to 24 months after discharge from a US or Canadian hospital. Data analysis was performed from May 2024 to January 2025. Exposure: Hospitalization for MIS-C. Main Outcomes and Measures: A central study site remotely administered a structured interview, surveys, neuropsychological assessment, and neurologic examination. Group differences were assessed using generalized estimating equations, accounting for matching. Variables extracted from hospital records included intensive care unit admission and echocardiographic left ventricular ejection fraction (LVEF). Results: Overall, 95 participants were included in the study; 93 of 108 participants (86%) returned from the year 1 study and 2 participants were added in year 2 (median [IQR] age, 12.6 [11.0-15.7] years; 38 [40%] female and 57 [60%] male). Fifty-nine patients with MIS-C (mean [SD] age, 13.2 [4.0] years; 39 [66%] male) and 36 controls (mean [SD] age, 13.5 [3.5] years; 18 [50%] male) enrolled. In year 2, the MIS-C group was similar to controls on all outcome measures, except they had more somatization symptoms (Behavior Assessment Scale for Children, Third Edition mean [SD] somatization score, 52.1 [13.0] vs 46.5 [8.5]; mean difference, 5.2; 95% CI, 1.3-9.1). Within the MIS-C group, scores generally improved between initial and follow-up evaluations, a finding that was not observed in controls. Eight of 13 children with MIS-C (62%) who had abnormal neurologic examination findings in year 1 had normal examination findings by year 2. Among patients with MIS-C, measures of higher illness severity during hospitalization were associated with worse executive function in year 2 (National Institutes of Health [NIH] List Sort Working Memory Test score, -7.3 points per intensive care unit admission vs not [95% CI, -14.3 to -0.3 points] and -5.8 points per LVEF category change [95% CI, -9.1 to -2.6 points]; verbal fluency switching score, -0.8 points per LVEF category change [95% CI, -1.5 to -0.1 points]). Conclusions and Relevance: In this longitudinal, matched cohort study of children with MIS-C and controls followed up sequentially up to 2 years after hospital discharge, children with MIS-C had more somatic symptoms than control children. Overall, however, patients with MIS-C had improved neurologic and psychological outcomes between the testing intervals, performing similarly to controls on most measures by year 2 follow-up. These findings suggest that these concerns may improve over time.

  PublisherOA PDFDOI

• Motor function testing rates and outcomes in Duchenne muscular dystrophy with comorbid autism and attention-deficit/hyperactivity disorder

  Neuromuscular Disorders · 2025-01-30 · 3 citations

  article
  PublisherDOI

• P-919. Epidemiology of Cerebral Sinovenous Thrombosis in Children with Acute Bacterial Intracranial Infection: a Single-Institution Retrospective Study

  Open Forum Infectious Diseases · 2025-01-29

  articleOpen accessSenior author

  Abstract Background Cerebral sinovenous thrombosis (CSVT) is a known complication of acute bacterial intracranial infection. The objective of this study is to determine the annual proportion of, risk factors for, and outcomes in children with CSVT secondary to acute bacterial intracranial infection.Figure 1:Annual proportion of CSVT in children with acute bacterial intracranial infection between Jan 1, 2015 and December 31, 2022 Methods Retrospective single-center cohort study of children age 1-18 years hospitalized at a tertiary care children’s hospital for acute bacterial intracranial infection between 01/01/2015 and 02/01/2023. Cases were identified by discharge ICD codes for “meningitis,” “meningoencephalitis,” “subdural empyema,” “epidural abscess,” and “brain abscess.” Medical charts were manually screened to ascertain the diagnosis and to abstract relevant clinical data. Multivariate models were built to examine risk factors for CSVT. Results One hundred and three patients were included. Median age was 10.2 [5.9,12.7] years. 31/103 (30%) had CSVT. Annual proportion of CSVT did not vary; however, the total number of cases of intracranial infection rose during the study period. Patients with CSVT were no different from those without CSVT by demographics, vaccination status, neurologic signs or symptoms at presentation, or causative organisms. Non-pneumococcal streptococcus species were the most common causative organisms, found in 37/103 (36%) children. Need for neurosurgical intervention (aOR=11.6, p=0.027), need for ENT intervention (aOR=6.1, p=0.013), temporal location of infection (aOR=7.9, p=0.004), and concurrent mastoiditis (aOR=29.5, p=0.004) were associated with CSVT. The sigmoid sinus (55%, 17/31), transverse sinus (42%, 13/31), jugular vein (45%, 14/31), and superior sagittal sinus (45%, 14/31) were the most common locations for CSVT. Two patients (6%) had venous infarction; one (3%) had venous hemorrhage. A higher proportion of children with CSVT had behavioral concerns (p=0.020) and learning concerns (p=0.025) than children without CSVT. Conclusion CSVT is common in acute bacterial intracranial infection. Consider empiric surveillance in children with acute bacterial intracranial infection with mastoiditis, temporal location of infection, and/or those who require surgical intervention. Outcomes in this population should be further explored. Disclosures All Authors: No reported disclosures

  PublisherDOI

• Lyme Disease and Papilledema: A Retrospective Study on Clinical Characteristics and Outcomes

  Journal of Child Neurology · 2024-08-01 · 2 citations

  articleOpen accessSenior author

  OBJECTIVE: Describe the clinical characteristics, treatment strategies, and outcome data of children with papilledema associated with Lyme disease at a large tertiary care pediatric hospital. METHODS: Retrospective cohort study of children 1-18 years old who received care at our institution between 1995 and 2019 with concurrent diagnoses of papilledema and Lyme disease. Data were abstracted from records and prospective family surveys. RESULTS: Among 44 children included (median age 9.7 years), 66% (29/44) had additional cranial neuropathies, and 78% (32/41) had cerebrospinal fluid pleocytosis. All children were treated with antibiotics (39% oral, 55% intravenous, 7% both); 61% (27/44) were also treated with oral acetazolamide. Symptoms fully resolved in 86% (30/35) of children with follow-up data. Proportion recovered did not significantly differ by antibiotic administration route or presence/absence of cerebrospinal fluid pleocytosis. CONCLUSIONS: Papilledema in Lyme disease may occur with or without cerebrospinal fluid pleocytosis. Most children recover without residual deficits following treatment, although exceptions exist.

  PublisherOA PDFDOI

• Severe Pediatric Neurological Manifestations With SARS-CoV-2 or MIS-C Hospitalization and New Morbidity

  JAMA Network Open · 2024-06-10 · 17 citations

  articleOpen access

  Importance: Neurological manifestations during acute SARS-CoV-2-related multisystem inflammatory syndrome in children (MIS-C) are common in hospitalized patients younger than 18 years and may increase risk of new neurocognitive or functional morbidity. Objective: To assess the association of severe neurological manifestations during a SARS-CoV-2-related hospital admission with new neurocognitive or functional morbidities at discharge. Design, Setting, and Participants: This prospective cohort study from 46 centers in 10 countries included patients younger than 18 years who were hospitalized for acute SARS-CoV-2 or MIS-C between January 2, 2020, and July 31, 2021. Exposure: Severe neurological manifestations, which included acute encephalopathy, seizures or status epilepticus, meningitis or encephalitis, sympathetic storming or dysautonomia, cardiac arrest, coma, delirium, and stroke. Main Outcomes and Measures: The primary outcome was new neurocognitive (based on the Pediatric Cerebral Performance Category scale) and/or functional (based on the Functional Status Scale) morbidity at hospital discharge. Multivariable logistic regression analyses were performed to examine the association of severe neurological manifestations with new morbidity in each SARS-CoV-2-related condition. Results: Overall, 3568 patients younger than 18 years (median age, 8 years [IQR, 1-14 years]; 54.3% male) were included in this study. Most (2980 [83.5%]) had acute SARS-CoV-2; the remainder (588 [16.5%]) had MIS-C. Among the patients with acute SARS-CoV-2, 536 (18.0%) had a severe neurological manifestation during hospitalization, as did 146 patients with MIS-C (24.8%). Among survivors with acute SARS-CoV-2, those with severe neurological manifestations were more likely to have new neurocognitive or functional morbidity at hospital discharge compared with those without severe neurological manifestations (27.7% [n = 142] vs 14.6% [n = 356]; P < .001). For survivors with MIS-C, 28.0% (n = 39) with severe neurological manifestations had new neurocognitive and/or functional morbidity at hospital discharge compared with 15.5% (n = 68) of those without severe neurological manifestations (P = .002). When adjusting for risk factors in those with severe neurological manifestations, both patients with acute SARS-CoV-2 (odds ratio, 1.85 [95% CI, 1.27-2.70]; P = .001) and those with MIS-C (odds ratio, 2.18 [95% CI, 1.22-3.89]; P = .009) had higher odds of having new neurocognitive and/or functional morbidity at hospital discharge. Conclusions and Relevance: The results of this study suggest that children and adolescents with acute SARS-CoV-2 or MIS-C and severe neurological manifestations may be at high risk for long-term impairment and may benefit from screening and early intervention to assist recovery.

  PublisherOA PDFDOI

• Severe Pediatric Neurological Manifestations With SARS-CoV-2 or MIS-C Hospitalization and New Morbidity

  Aston Publications Explorer (Aston University) · 2024-10-04

  articleOpen access

  Importance: Neurological manifestations during acute SARS-CoV-2-related multisystem inflammatory syndrome in children (MIS-C) are common in hospitalized patients younger than 18 years and may increase risk of new neurocognitive or functional morbidity. Objective: To assess the association of severe neurological manifestations during a SARS-CoV-2-related hospital admission with new neurocognitive or functional morbidities at discharge. Design, Setting, and Participants: This prospective cohort study from 46 centers in 10 countries included patients younger than 18 years who were hospitalized for acute SARS-CoV-2 or MIS-C between January 2, 2020, and July 31, 2021. Exposure: Severe neurological manifestations, which included acute encephalopathy, seizures or status epilepticus, meningitis or encephalitis, sympathetic storming or dysautonomia, cardiac arrest, coma, delirium, and stroke. Main Outcomes and Measures: The primary outcome was new neurocognitive (based on the Pediatric Cerebral Performance Category scale) and/or functional (based on the Functional Status Scale) morbidity at hospital discharge. Multivariable logistic regression analyses were performed to examine the association of severe neurological manifestations with new morbidity in each SARS-CoV-2-related condition. Results: Overall, 3568 patients younger than 18 years (median age, 8 years [IQR, 1-14 years]; 54.3% male) were included in this study. Most (2980 [83.5%]) had acute SARS-CoV-2; the remainder (588 [16.5%]) had MIS-C. Among the patients with acute SARS-CoV-2, 536 (18.0%) had a severe neurological manifestation during hospitalization, as did 146 patients with MIS-C (24.8%). Among survivors with acute SARS-CoV-2, those with severe neurological manifestations were more likely to have new neurocognitive or functional morbidity at hospital discharge compared with those without severe neurological manifestations (27.7% [n = 142] vs 14.6% [n = 356]; P < .001). For survivors with MIS-C, 28.0% (n = 39) with severe neurological manifestations had new neurocognitive and/or functional morbidity at hospital discharge compared with 15.5% (n = 68) of those without severe neurological manifestations (P = .002). When adjusting for risk factors in those with severe neurological manifestations, both patients with acute SARS-CoV-2 (odds ratio, 1.85 [95% CI, 1.27-2.70]; P = .001) and those with MIS-C (odds ratio, 2.18 [95% CI, 1.22-3.89]; P = .009) had higher odds of having new neurocognitive and/or functional morbidity at hospital discharge. Conclusions and Relevance: The results of this study suggest that children and adolescents with acute SARS-CoV-2 or MIS-C and severe neurological manifestations may be at high risk for long-term impairment and may benefit from screening and early intervention to assist recovery.

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Recent grants

• Altered Brain Structure and Function in Adolescents with Behaviorally Acquired HIV

  NIH · $904k · 2016–2022

Frequent coauthors

• Beth S. Slomine

  Kennedy Krieger Institute

  180 shared

• James R. Christensen

  Johns Hopkins University

  144 shared

• Richard Holubkov

  University of Utah

  144 shared

• Frank W. Moler

  University of Michigan–Ann Arbor

  144 shared

• Faye S. Silverstein

  University of Michigan–Ann Arbor

  108 shared

• J. Michael Dean

  University of Utah

  108 shared

• Russell Telford

  University of Utah

  72 shared

• J. Kwok

  Children's Hospital of Los Angeles

  72 shared