Medical Qualifications
MA (Molecular and Cellular Pathology) University of Cambridge 1992
MBBChir University of Cambridge 1994
MRCP (UK) Royal College of Physicians, London 1998
Certificate of Completion of Training Paediatric Neurology 2007
Additional Qualifications
I have completed undergraduate level courses with the Open University in Mathematics between 2002 and 2006 (210 credits) and Masters level courses in biomedical signal processing.
Cardiff University-Bond Solon Certificate in Civil Law 2016.
Key certifications
I am on the GMC Specialist Register since November 2007 as “Paediatrics/Paediatric Neurology (Paediatric Neurology)”.
I undertook a formal GMC prospectively-approved syllabus-based curriculum training in paediatric neurology for 3.5 years following standard training requirements in paediatrics. I gained a Certificate of Completion of Training in Paediatrics and Paediatric Neurology.
I am recognised as a trainer by the GMC.
I have a licence to practice.
I last revalidated in December 2019. I am next due to revalidate in December 2024.
Current Position: NHS
2007 to 2023: Consultant Paediatric Neurologist, North West England
Until May 2023, I was a full-time consultant paediatric neurologist at Alder Hey Children’s Hospital which is a tertiary multidisciplinary children’s hospital – one of the largest multi-specialty tertiary paediatric centres in Europe – for just over 16 years. I undertook practice in acute and chronic outpatient care across paediatric neurological conditions. I specialised in diagnosis and neurorehabilitation of acquired brain injuries, spasticity and movement disorder management but partook in spectrum of general paediatric neurology and acute on call.
I moved on in 2023, to explore novel areas of practice particularly to take a more life-span approach that is not feasible in a standalone children’s hospital, and now working part-time at Lancashire Teaching Hospitals, a combined adult-paediatric teaching hospital with a regional neurosciences centre, rehabilitation unit, tertiary neonatal unit and integrated neurodisability and community child health which is the basic requirement for taking forward a life-span approach.
Current Position: Private
I undertake work in private treating medical practice and medico-legal expert witness work in my areas of special expertise. This is in areas of childhood-onset brain injury and other neurological conditions in children and young people.
Clinical expertise
Acute paediatric neurology:
I previously undertook regular on-call on generally a 1 week in 6 basis but last few years this varied from 1 in 3 to 1 in 4. This included providing consultations for on-site intensive care, neurosurgery, cardiothoracic surgery, oncology and emergency departments. I did emergency consults for these and other specialties with acute onset neurological disorders. I admitted and manage children with complex neurological problems referred from across the North West England and North Wales regions.
Chronic conditions and ambulatory paediatric neurology:
I work 2 sessions currently in the NHS. I do weekly general paediatric neurology clinics receiving referrals from primary, secondary and tertiary care. I do regular outreach paediatric neurology clinics run jointly with the general paediatrician or community paediatrician at district general hospitals and community neurodevelopmental clinics respectively.
Main conditions managed: cerebral palsy, headache, epilepsy, sleep disorders, neurogenetics, neuromuscular diagnosis.
Sub-specialty expertise:
I previously led the regional child and adolescent spasticity and movement disorders management service for the North West. This included: assessment for oral spasticity medications, botulinum toxin, intrathecal baclofen, selective dorsal rhizotomy and deep brain stimulation. I ran multidisciplinary clinics with specialist developmental and neurophysiotherapists, occupational therapist, upper limb surgeon, and functional neurosurgeons.
I was the lead consultant for acute neurorehabilitation, supervising the care of children with acquired brain injuries requiring highly complex multidisciplinary rehabilitation team input. I interact regularly with physiotherapists, occupational therapists, speech and language therapists, neuropsychologists and teachers regarding acquired brain injury management as inpatient and long-term follow-up. I was responsible for developing the future direction of the neurorehabilitation service, as well as the overall rehabilitation agenda for the hospital.
I undertook neuro-oncology investigations and rehabilitation. I attended monthly multidisciplinary team rehabilitation meetings on children with known brain tumours and the brain tumour board when available.
I was the Service Group Lead for Paediatric neurology, neurosurgery, long-term ventilation and rehabilitation 2013 to 2017.
Education and Training
Before I became a consultant paediatric neurologist, I trained in Manchester, UK, for 3.5 years in a prospectively approved General Medical Council-recognised curriculum-based paediatric neurology training scheme, appointed after national competition, whilst completing Royal College of Paediatrics and Child Health training requirements for paediatric training, originally training in North London before moving to the North West. I was thus entered on to the Specialist Register with a Certificate of Completion Training with dual registration in Paediatrics and Paediatric Neurology.
I was an Honorary Senior Lecturer at Edge Hill University Medical School.
I was the course director of “Mild Traumatic Brain Injury and Concussion in Children: A Practical Approach” national study day held at Alder Hey Hospital in February 2018.
Successfully supervised 2 medical students in gaining a research MPhil.
Tutor for the British Paediatric Neurology Association Distance Learning course.
I have been a course instructor on the British Paediatric Neurology Association Childhood Headache Training course.
Regional training advisor for paediatric neurology for Health Education England North West (Mersey Deanery).
Postgraduate training of doctors in general paediatrics, child psychiatry, paediatric neurology, adult neurology, and adult rehabilitation medicine.
Current and recently completed research
I was principal investigator on industry-funded Phase III double-blind placebo RCT of Sativex, a drug for spasticity in children with cerebral palsy and traumatic brain injury. I recruited 12 of 72 patients in this multi-centre international study across 14 sites. 2014 to 2017 (submitted for publication).
Co-applicant, investigator and PhD supervisor for a research physiotherapist on the ASPECT study: a National Institute of Health Research/Health Education England funded study on ataxia rehabilitation of children after posterior fossa tumour, including a multi-centre randomised controlled trial of a virtual reality therapy intervention for ataxia (2017 to 2021).
Chief applicant of University of Liverpool-Alder Hey Children’s Hospital Hugh Greenwood Legacy Fund: Development of clinical neurophysiological biomarkers of fatigue in children with acquired brain injury. 2018 onwards. This is my current main active area of research.
Knowledge Exchange Fund: software development for invasive EEG monitoring 2018 to 2019.
Advanced neuroimaging in cerebellar mutism syndrome and ataxia after cerebellar tumours. 2012 onwards.
I was involved in the Advancing Rett Syndrome Cannabinoid Research (ARCH) GWP42003-P randomised controlled trial, Principal Investigator (2019 onwards); and Chief Investigator of Open-Label Extension (2019 onwards until unfortunate cessation during Covid 19 pandemic).
Co-applicant of University of Liverpool-Alder Hey Children’s Hospital Hugh Greenwood Legacy Fund: Investigating the effects of radiation therapy on the behaviour of neural stem cells and oligodendrocyte progenitor cells of human origin (2019 to 2021)
Publications
Book chapters
Contributed the chapters on cerebral palsy, hydrocephalus, and spinal disorders in Oxford Specialist Handbook of Paediatric Neurology, 1st and 3rd Editions (Oxford University Press). Last published 2017.
Surgical complications. Kumar R and Mallucci C. In Ozek et al (eds). Posterior fossa tumours in children. Springer International Publishing, Switzerland. DOI 10.1007/978-3-319-11274-9_62.
Peer-reviewed publications after 2012
Clinical Reasoning: acute ptosis in a young child. Das D, Spinty S, Kumar R. Neurology 2012; 79 (8):e155-e160.
Baclofen in community paediatric management of hypertonia. Kumar R and George B. Arch Dis Child 2013; 98: 162.
A decision analysis tool for the assessment of posterior fossa tumour surgery outcomes in children – the “Liverpool Neurosurgical Complication Causality Assessment Tool”. Zakaria R, Ellenbogen J, Graham C, Pizer B, Mallucci C, Kumar R. Child’s Nervous System 2013 ;29(8):1277-83.
Efficacy and tolerability of zolmitriptan oro-dispersible wafer in treatment of childhood migraine. Kerrison C, Wright F, Piper J, Kumar R, Hawcutt D. Eur J Hosp Pharm 2013 (doi: 10.1136/ejhpharm-2013-000347).
Indwelling intrathecal catheter with subcutaneous abdominal reservoir: a viable baclofen delivery system in severely cachectic patients. Waqar M, Ellenbogen J, Kumar R, Sneade C, Zebian M, Williams D, Pettorini B. J Neurosurg Ped. 2014 DOI: 10.3171/2014.6.PEDS13686.
Diffusion abnormalities on intra-operative MRI as an early predictor for the risk of posterior fossa syndrome. Avula S, Kumar R, Pizer B, Pettorini B, Garlick D, Mallucci C. Neuro-Oncology 2015; 17(4):614-22.
Characterization of human disease phenotypes associated with mutations in TREX1, RNASEH2A, RNASEH2B, RNASEH2C, SAMHD1, ADAR and IFIH1. Crow et al 2014; AJ Med Genet Part A. 9999: 1-17.
Inter-rater reliability and validity of two ataxia rating scales in children with brain tumours. Hartley H, Pizer B, Lane S, Sneade C, Pratt R, Bishop A, Kumar R. Childs Nerv Syst. 2015 May; 31(5):693-7. doi: 10.1007/s00381-015-2650-5.
Advanced neuroimaging of cerebral palsy following extremely preterm birth. Kumar R. Dev Med Child Neurol. 2015 doi: 10.1111/dmcn.12871.
Posterior fossa syndrome after brain tumour resection: review of pathophysiology and a new hypothesis on its pathogenesis. Avula S, Mallucci C, Kumar R, Pizer B. Childs Nerv Syst. 2015; 31: 1859-1867.
Identifying quantitative imaging features of Posterior Fossa Syndrome in longitudinal MRI. Spiteri M, Windridge D, Avula S, Kumar R, Lewis E. Journal of Medical Imaging 2015;2(4):044502.
A pilot study of obesogenic eating behaviors in children with migraine. Ray STJ, Singh SB, Halford JCG, Harrold JA, Kumar R. J Child Neurol 2016; 31(7):895-8.
Mutations in SNORD118 cause the cerebral microangiopathy leukoencephalopathy with calcifications and cysts. Nat Genet 2016. doi: 10.1038/ng.3661.
Late assessment of neurodevelopmental impairment in children with fetal ventriculomegaly. Dakson A, Newton R, Russell S, Kumar R. J Pediatr Neurol 2016; 14(04): 135-140.
Post-operative pediatric cerebellar mutism syndrome and its association with hypertrophic olivary degeneration. Avula S, Spiteri M, Kumar R, Lewis E, Harave S, Windridge D, Ong C, Pizer B. Quant Imaging Med Surg. 2016 Oct;6(5):535-544.
Development of a pre-operative scoring system for predicting risk of post-operative paediatric cerebellar mutism syndrome. Liu JF, Dineen RA, Avula S, Chambers T, Dutta M, Jaspan T, MacArthur DC, Howarth S, Soria D, Quinlan P, Harave S, Ong CC, Mallucci CL, Kumar R, Pizer B, Walker DA. Br J Neurosurg. 2018 Feb 12:1-10.
Feeding aversion in children with neurodisability and its assessment using CEBQ: a tertiary feeding clinic experience. Kulshreshtha R, Dalzell M, Kumar R. HSOA Journal of Gastroenterol Hepatology Res 2018; 3: 017.
Incidence and prognostic factors of ataxia in children with posterior fossa tumours. Hartley H, Pizer B, Lane S, Sneade C, Williams R, Mallucci C, Bunn L, Kumar R. Neuro-Oncology Practice 2019; 6: 185 – 193.
Pharmacological management of abnormal tone and movement in cerebral palsy. Lumsden DE, Crowe B, Basu A, Amin S, Devlin A, DeAlwis Y, Kumar R, Lodh R, Lundy CT, Mordekar SR, Smith M, Cadwgan J. Arch Dis Child 2019; 104(8):775-780.
Post-operative cerebellar mutism syndrome: rehabilitation issues. Paquier PF, Walsh KS, Docking KM, Hartley H, Kumar R, Catsman-Berrevoets CE. Childs Nerv Syst. 2019 Jun 20 (accepted)
Fully-Automated Identification of Imaging Biomarkers for Post-Operative
Cerebellar Mutism Syndrome Using Longitudinal Paediatric MRI. Spiteri M, Guillemaut JY, Windridge D, Avula S, Kumar R, Lewis E. Neuroinformatics. 2019 Jun 28. doi: 10.1007/s12021-019-09427-w.
A clinical diagnostic algorithm for early onset cerebellar ataxia. Brandsma R, Verschuuren-Bemelmans CC, Amrom D, Barisic N, Baxter P, Bertini E, Blumkin L, Brankovic-Sreckovic V, Brouwer OF, Bürk K, Catsman-Berrevoets CE, Craiu D, de Coo IFM, Gburek J, Kennedy C, de Koning TJ, Kremer HPH, Kumar R, Macaya A, Micalizzi A, Mirabelli-Badenier M, Nemeth A, Nuovo S, Poll-The B, Lerman-Sagie T, Steinlin M, Synofzik M, Tijssen MAJ, Vasco G, Willemsen MAAP, Zanni G, Valente EM, Boltshauser E, Sival DA. Eur J Paediatr Neurol. 2019 Aug 10. pii:
S1090-3798(19)30027-3. doi: 10.1016/j.ejpn.2019.08.004.
Exercise and Physical Therapy Interventions for Children with Ataxia: A Systematic Review. Hartley H, Cassidy E, Bunn L, Kumar R, Pizer B, Lane S, Carter B. Cerebellum. 2019;18(5):951-968.
E-survey of current international physiotherapy practice for children with ataxia following surgical resection of posterior fossa tumour. Hartley H, Carter B, Bunn L, Pizer B, Lane S, Kumar R, Cassidy E. Journal of Rehabilitation Medicine 2020; doi: 10.2340/20030711-100002
Efficacy and safety of nabiximols cannabinoid medicine for paediatric spasticity in cerebral palsy or traumatic brain injury: a randomized controlled trial. Fairhurst C, Kumar R, Checketts D, Tayo B, Turner S. Dev Med Child Neurol. 2020 doi: 10.1111/dmcn.14548. PubMed PMID: 32342496.
Leukoencephalopathy with calcifications and cysts: Genetic and phenotypic spectrum. Crow et al AJMG Published 7 October 2020; https://doi.org/10.1002/ajmg.a.61907
cGAS-mediated induction of type I interferon due to inborn errors of histone pre-mRNA processing. Uggenti, C., Lepelley, A., Depp, M. et al. Nat Genet (2020). https://doi.org/10.1038/s41588-020-00737-3
Intrathecal baclofen pumps in the management of hypertonia in childhood: a UK and Ireland wide survey. Lodh R, Amin S, Ammar A, et al Archives of Disease in Childhood Published Online First: 14 April 2021. doi: 10.1136/archdischild-2020-321487
Ataxia and mobility in children following surgical resection of posterior fossa tumour: A longitudinal cohort study. Hartley H, Lane S, Pizer B, Bunn L, Carter B, Cassidy E, Mallucci C, Kumar R. Childs Nerv Syst. 2021 Sep;37(9):2831-2838. doi: 10.1007/s00381-021-05246-0. Epub 2021 Jul 7. PMID: 34232381; PMCID: PMC8423635.
The effect of GMFCS level, age, sex, and dystonia on multi-dimensional outcomes after selective dorsal rhizotomy: prospective observational study. Gillespie CS, George AM, Hall B, Toh S, Islim AI, Hennigan D; Alder Hey Physiotherapy Group, Kumar R, Pettorini B. Childs Nerv Syst. 2021 May;37(5):1729-1740. doi: 10.1007/s00381-021-05076-0. Epub 2021 Feb 18. PMID: 33599808; PMCID: PMC8084767.
Neurological manifestations of SARS-CoV-2 infection in hospitalised children and adolescents in the UK: a prospective national cohort study. Ray STJ, et al. Lancet Child & Adolescent Health. 2021; 5 (9): P631-641.
Higher visual function deficits in children with cerebral visual impairment and good visual acuity. Arvind Chandna, Saeideh Ghahghaei, Susan Foster, Ram Kumar. Frontiers in Human Neuroscience, 2021 (accepted).
Motion processing deficits in children with cerebral visual impairment and good visual acuity. Chandna A, Nichiporuk N,Nicholas S, Kumar R, Norcia AM. Invest Ophthalmol Vis
Sci. 2021 (accepted).
Basilar Artery Vasospasm as a Cause of Post-Operative Cerebellar Mutism Syndrome. Deghedy M, Pizer B, Kumar R, Mallucci C, Avula S. Case Rep Pediatr. 2022 Feb 10;2022:9148100. doi: 10.1155/2022/9148100. PMID: 35186341; PMCID: PMC8853815.
Idiopathic intracranial hypertension in children with obesity. , , . Acta Paediatr. 2022; 111: 1420– 1426. doi:10.1111/apa.16343
Prevalence of dysphagia following posterior fossa tumour resection in children: the Alder Hey experience. Wright, S.H., Blumenow, W., Kumar, R. et al. Childs Nerv Syst 39, 609–616 (2023). https://doi.org/10.1007/s00381-022-05774-3.
The utility of methylphenidate for fatigue in long-term neurological conditions: A meta-analytical review. Hagan, A and Kumar, R. Clinical Neuropharmacology ():10.1097/WNF.0000000000000572, October 19, 2023. | DOI: 10.1097/WNF.0000000000000572.
Care and three-year outcomes of children with Benign Epilepsy with Centro-Temporal Spikes in England. Steinruecke et al. 2023; Epilepsy & Behavior. https://doi.org/10.1016/j.yebeh.2023.109465.
Baló’s Concentric Sclerosis presenting asymptomatically in a child: clinico-radiological-pathological correlation. BMJ Case Reports 2023 (accepted)
Professional Memberships
British Paediatric Neurology Association
Royal College of Physicians (London)
European Paediatric Neurology Society
International Pediatric Brain Injury Society
Newborn Brain Society
Children’s Cancer and Leukaemia Group
Society for the Study of Behavioural Phenotypes