About

Sudha Vani Kilaru Kessler, M.D., is an Associate Professor of Neurology at the Children's Hospital of Philadelphia. She serves as Program Director for the Pediatric Epilepsy Fellowship at Children's Hospital of Philadelphia and the University of Pennsylvania, as well as Program Director for the Child Neurology Residency at the Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania. Her clinical expertise includes pediatric epilepsy, EEG, antiepileptic drugs, epilepsy surgery, and the ketogenic diet. Her research focuses on pediatric epilepsy, clinical epidemiology, brain stimulation, and clinical trials. Dr. Kessler has contributed to the field through her work on novel screening tools for absence seizures, neurogenesis, neuromodulation safety, and surgical outcomes in pediatric epilepsy, and has published extensively on these topics.

Research topics

• Medicine
• Neuroscience
• Biology
• Psychiatry
• Genetics
• Intensive care medicine
• Cell biology
• Emergency medicine
• Multimedia
• Family medicine
• Pediatrics
• Psychology
• Internal medicine

Selected publications

• Medication Barriers in Pediatric Patients With Epilepsy

  Pediatric Neurology · 2026-01-30 · 1 citations

  article
  PublisherDOI

• Low Frequency Stimulation and Seizure Induction in Pediatric and Young Adult Patients With Drug Resistant Epilepsy Undergoing Stereoelectroencephalography

  Journal of Clinical Neurophysiology · 2026-03-13

  article

  PURPOSE: Describe the tolerability and outcome of direct brain stimulation for seizure induction in children and young adults undergoing intracranial electroencephalography. METHODS: Patients received low frequency stimulation (LFS) consisting of 30 seconds of 1 Hz bipolar, biphasic brain stimulation. A subset also received high frequency stimulation (HFS) for clinical purposes. Clinical data regarding epilepsy characteristics, stimulation, and outcomes were collected. RESULTS: Fifty-four patients (aged 1.8 to 23.4 years) with pediatric onset epilepsy were enrolled at Children's Hospital of Philadelphia and the Hospital of the University of Pennsylvania. Side effects during LFS included focal sensation (22%) and motor responses (41%). Non-seizure electrographic abnormalities were noted during stimulation in 87% of patients. During LFS, typical clinical seizures were seen in 24% of patients. During HFS (50 Hz), 58% of 36 patients had seizures (71% typical semiology). In 30% of patients, stimulated typical clinical seizures identified a contact not previously identified as part of the seizure onset zone. Of 43 patients who went on to have resection, ablation, or neuromodulation, 39 patients had ≥12 months of follow-up. Although 84% of 19 patients with stimulated typical clinical seizures had a good outcome, 60% of 20 patients with atypical or no clinical seizures during stimulation had good outcomes (P = 0.09). CONCLUSIONS: LFS is well tolerated in pediatric and young adult DRE patients and in one fourth of cases identifies potential additional nodes of the seizure network. These data, consistent with adult studies, affirm that LFS has a role complementing HFS in evaluating pediatric DRE patients undergoing stereoelectroencephalography.

  PublisherDOI

• Cross-species analysis of adult hippocampal neurogenesis reveals human-specific gene expression but convergent biological processes

  Nature Neuroscience · 2025-08-11 · 13 citations

  article
  PublisherDOI

• Safety profile of intracranial neuromodulation for drug-resistant epilepsy in children

  Journal of Neurosurgery Pediatrics · 2025-05-02 · 3 citations

  article

  OBJECTIVE: Children with drug-resistant epilepsy (DRE) in whom resection or disconnective surgeries are not recommended can still benefit from neurostimulation. Vagus nerve stimulation (VNS) is FDA approved for those aged 4 years and older, but intracranial stimulators, that is, responsive neurostimulation (RNS) and deep brain stimulation (DBS) devices, are only approved for those aged 18 years and older. Studies in adults and early experience in children suggest that intracranial stimulation may be more effective than VNS but with higher risk. This risk has not been examined in large pediatric cohorts. This study aimed to evaluate the safety profile of RNS and DBS for pediatric DRE as well as the possible risk factors for wound-related complications. METHODS: This retrospective study examined the records of DRE patients who underwent RNS or DBS at Children's Hospital of Philadelphia from November 2017 to March 2024 with at least 6 months of follow-up. DBS electrodes were placed in the anterior or centromedian nucleus of the thalamus. RNS electrodes were placed in seizure foci. RESULTS: A total of 54 patients, aged 6-22 years, underwent intracranial stimulator implantation for DRE (24 DBS, 30 RNS). The mean follow-up was 24.4 ± 15.3 months (median 21 months, range 6-69 months). Five (9.3%) patients returned to surgery, 3 (5.6%) of whom required explant and 1 (1.9%) of whom required explant and also had a surgical site infection (SSI). Prior craniotomy was a significant risk factor for wound-related complications (p = 0.0046 in all patients, p = 0.0375 in patients < 18 years). No patient experienced hemorrhage, lead malposition, device malfunction, or long-term stimulation-induced paresthesia, depression, or memory loss. The overall responder rates, defined by achieving 50% or greater reduction in seizure frequency, were 54% in the RNS cohort and 73% in the DBS cohort at the 12-month follow-up. CONCLUSIONS: To the best of the authors' knowledge, this study represents the largest single-center series of intracranial stimulation for pediatric DRE. In comparison with established rates of SSI and explant in adults (12% and 7.0% in the RNS pivotal trial and 13% and 8.6% in the DBS SANTE [Stimulation of the Anterior Nucleus of the Thalamus for Epilepsy] trial, respectively), the present cohort demonstrated favorable rates of 1.9% and 5.6%, respectively. Studies with larger pediatric DRE cohorts are needed with longer follow-up and seizure outcomes to elucidate the risk/benefit balance of intracranial stimulation in children.

  PublisherDOI

• Comparative molecular landscapes of immature neurons in the mammalian dentate gyrus across species reveal special features in humans

  bioRxiv (Cold Spring Harbor Laboratory) · 2025-02-17

  preprintOpen access

  Immature dentate granule cells (imGCs) arising from adult hippocampal neurogenesis contribute to plasticity, learning and memory, but their evolutionary changes across species and specialized features in humans remain poorly understood. Here we performed machine learning-augmented analysis of published single-cell RNA-sequencing datasets and identified macaque imGCs with transcriptome-wide immature neuronal characteristics. Our cross-species comparisons among humans, monkeys, pigs, and mice showed few shared (such as DPYSL5), but mostly species-specific gene expression in imGCs that converged onto common biological processes regulating neuronal development. We further identified human-specific transcriptomic features of imGCs and demonstrated functional roles of human imGC-enriched expression of a family of proton-transporting vacuolar-type ATPase subtypes in development of imGCs derived from human pluripotent stem cells. Our study reveals divergent gene expression patterns but convergent biological processes in the molecular characteristics of imGCs across species, highlighting the importance of conducting independent molecular and functional analyses for adult neurogenesis in different species.

  PublisherOA PDFDOI

• Epilepsy Genetics

  CONTINUUM Lifelong Learning in Neurology · 2025-02-01 · 1 citations

  article1st authorCorresponding
  PublisherDOI

• Salvage Trans‐Sylvian Peri‐Insular Hemispherotomy After Embolic Hemispherectomy

  Annals of the Child Neurology Society · 2025-03-18 · 1 citations

  articleOpen access

  ABSTRACT Background Hemispherectomy and hemispherotomy represent well‐established treatments for drug‐resistant hemispheric epilepsy. An alternative endovascular procedure has been explored for cases with challenging surgical anatomy, which seeks to achieve the clinical effect of hemispherectomy via embolization of the major cerebral arteries and subsequent hemispheric infarction. Neither the safety nor effectiveness of this procedure has been established. Patient Description A 4‐month‐old girl with a history of drug‐resistant focal epilepsy due to left‐sided hemimegalecephaly previously treated with endovascular hemispherectomy at another institution presented for surgical evaluation due to ongoing electroclinical seizures despite multiple antiseizure medications. Pre‐operative magnetic resonance imaging (MRI) revealed viable tissue, including mesial temporal structures, and a salvage hemispherotomy was performed. The embolized cortex was surprisingly well‐perfused intra‐operatively. Postoperatively, she has had no further seizures at 1‐year follow‐up. Conclusion Embolization of the three large hemispheric arteries achieved neither complete hemispheric destruction nor complete disconnection in this case and did not resolve the patient's seizures, necessitating salvage hemispherotomy. While it is difficult to draw definitive conclusions from a single patient's course, our experience suggests that endovascular hemispheric destruction may not be an effective substitute for surgical hemispherectomy or hemispherotomy.

  PublisherOA PDFDOI

• Epilepsy Genetics

  CONTINUUM Lifelong Learning in Neurology · 2025-02-01 · 2 citations

  review1st authorCorresponding

  OBJECTIVE: This article reviews essential concepts and terminology in epilepsy genetics, discusses current guidance on when and how to pursue genetic evaluation, provides an overview of genetic syndromes, and offers illustrative examples of the effect of genetic diagnosis in epilepsy patient care. LATEST DEVELOPMENTS: The growing availability of next-generation genetic sequencing methods for clinical use provides an opportunity to make etiologic diagnoses in a larger number of epilepsy patients, which can affect therapeutic management, prognostic counseling, surveillance for comorbid conditions, and other aspects of epilepsy care. Exome and genome sequencing may have high diagnostic yields in patients with unexplained epilepsy. The body of knowledge in epilepsy genetics is growing more complex, not only because of gene discovery but also because of an increasingly nuanced understanding of the varying pathophysiologic effects of specific types of variation within epilepsy genes. ESSENTIAL POINTS: Genetic testing plays a key role in the evaluation of epilepsy patients. Clinicians caring for patients with epilepsy should understand patient selection, test selection, and result interpretation in genetic testing. The recommended first-line test in most patients is exome or genome sequencing.

  PublisherDOI

• Essential Components of Child Neurology Training: Program Director Consensus Recommendations

  Annals of the Child Neurology Society · 2025-09-17 · 1 citations

  articleOpen access

  ABSTRACT Objective We aimed to develop a program director–derived model of essential components of child neurology residency training. Methods All 79 child neurology residency programs in the United States were invited to submit a block diagram with 48 months of required rotations, the minimum clinical requirement across all approved pathways. These block diagrams were then analyzed for consensus. Program directors were anonymously surveyed regarding whether a child neurology resident could be adequately trained using the consensus curriculum if implemented in either a 4‐ or a 5‐year training program, and whether 4 years of residency could provide adequate training. Results Fifty of 79 residency programs (63%) submitted a block diagram (54% in pediatrics departments, 46% in neurology departments). Greater than 75% of program directors recommended the following rotations with the average number of months recommended across all program directors in parentheses: pediatric inpatient/hospital medicine (3), pediatric non‐consult intensive care (3), healthy newborn (0.5), pediatric acute/emergency care (1), genetics (1), child development (1), child neurology inpatient/consults (8), child neurology general outpatient (4), child psychiatry (1), adult neurology inpatient/consults (3), neurology specialties outpatient (4), electroencephalography (2), neuroradiology (1), and electives (7). Of the program directors (53 of 79, 67%) who completed the post‐survey, 87% agreed that these requirements would be adequate, and 89% agreed that child neurologists could be adequately trained for independent practice within 4 years. Interpretation The program director consensus supports modification of existing child neurology training requirements, with general agreement that 4 years of clinical training would be adequate.

  PublisherOA PDFDOI

• Two-year outcomes following modified transsylvian peri-insular hemispherotomy

  Child s Nervous System · 2025-04-25

  reviewOpen access

  PURPOSE: Hemispherotomy is an effective treatment for well-selected patients with drug-resistant hemispheric epilepsy. Successful hemispherotomy leading to seizure cessation has been associated with improved neurodevelopmental outcomes and reduced healthcare utilization. This study reports seizure outcomes and complications in a large, consecutive, single-surgeon series of pediatric hemispherotomy cases using a surgical approach with modifications to previously-reported techniques. METHODS: All patients undergoing transsylvian peri-insular hemispherotomy for drug-resistant hemispheric epilepsy between May 2017 and April 2021 by a single surgeon were prospectively enrolled in an epilepsy surgery registry. With retrospective review of medical records, data were collected on baseline characteristics (demographics, epilepsy history, anti-seizure medications, neurodevelopmental status, EEG features, and imaging characteristics), operative complications, hospital course, and seizure outcomes (Engel scale at 12- and 24-month follow-up). RESULTS: All 32 consecutive patients (aged 15 months-19 years) were seizure-free (Engel Class 1) 12 and 24 months after hemispherotomy. At 12 months, 31 patients (97%) had Engel Class 1A outcomes, and 1 patient (3%) had an Engel Class 1D outcome. These results were maintained through 24-month follow-up. Among 31 patients taking anti-seizure medications before surgery, 22 (71%) were weaned off all agents by 24 months. One patient (3%) developed post-operative hydrocephalus requiring ventriculoperitoneal shunt placement. CONCLUSION: In an etiologically heterogeneous cohort of patients undergoing hemispherotomy for drug-resistant epilepsy, a modified transsylvian peri-insular technique led to high rates of sustained seizure freedom with minimal complications.

  PublisherOA PDFDOI

Frequent coauthors

• Nicholas S. Abend

  Children's Hospital of Philadelphia

  138 shared

• Dennis Dlugos

  University of Pennsylvania

  105 shared

• Shavonne L. Massey

  Children's Hospital of Philadelphia

  84 shared

• Shlomo Shinnar

  Montefiore Medical Center

  69 shared

• Tracy A. Glauser

  Cincinnati Children's Hospital Medical Center

  69 shared

• Peggy O. Clark

  65 shared

• France W. Fung

  University of Pennsylvania

  61 shared

• Avital Cnaan

  60 shared

Labs

• Kessler LabPI

Education

• M.S.C.E., Center for Clinical Epidemiology and Biostatistics

  Univerisity of Pennsylvania

  2013

• M.D.

  Baylor College of Medicine

  2001

• B.A., English Literature

  Yale University

  1996