MY TOUGHEST CASE
Diagnostic Dilemmas and New Normals
Dr. Ann Tilton is a member of an exclusive club. There are only about 1,200 pediatric neurologists in the U.S. and Canada, says Tilton; Louisiana has just a handful and some states have only one.
For Tilton, the specialty is fascinating. A pediatric neurologist is the “Sherlock Holmes” of medicine, she says, piecing together a diagnosis from a variety of tests. Tilton, who graduated magna cum laude from Texas A&M, went to medical school at the University of Texas Medical Branch in Galveston and did a double residency in pediatrics and neurology at UT Southwestern Medical School in Dallas. During her residency, she says, “behind every door [was] a diagnosis I’d never seen before.”
After practicing in Dallas, Tilton moved to New Orleans with her husband, a native of the city. He is a cardiologist at East Jefferson General Hospital.
Today, she’s a professor of neurology and pediatrics at LSU Health Sciences Center and practices at Children’s Hospital, where she is co-director of the Rehabilitation Center. She also established and directs the center’s Comprehensive Spasticity Program. For her contributions to her field, Tilton received the Hower Award from the Child Neurology Society in 2012.
Since she began practicing, Tilton has seen many advances in her field. Vaccinations, for example, have lowered the numbers of meningitis cases, and education about the dangers of aspirin for children has led to a big decrease in the number of Reye’s Syndrome cases. Better imaging methods also give neurologists better information to go on, Tilton says, which enables them to sharpen their diagnoses.
At Children’s Hospital’s Rehab Center, teams of physical and occupational therapists, speech therapists, dieticians and physicians deal with youngsters who have suffered neurological trauma from car accidents and head and spine injuries.
Her toughest cases, Tilton says, are when a child presents a “diagnostic dilemma.” Equally tough is handling the problems an entire family has to deal with when a child is injured or ill. “Children are resilient,” she says. “A lot of the kids do well, and we get to see them come back.” Parents, though, have to learn to deal with a “new normal,” one that differs drastically from the life they were living.
Tilton also treats children who have suffered strokes, due to clotting problems, trauma, infections or birth defects. Here again, children do well because they have such a strong ability to compensate.
“They are more flexible,” she says.
Other areas of interest to Tilton are cerebral palsy and Duchenne’s muscular dystrophy. She also enjoys her teaching. Child neurology has a very high degree of job satisfaction, she says, and those who go into the specialty can practice in just about any region of the country.
In addition to traveling and spending time with her husband and four children, Tilton enjoys getting to see her former patients return for visits. “They become part of our family,” she says, and it’s always uplifting to see how far they have come.