Harriet Kang, MD
Pediatrics, Neurology, Pediatric Neurology
Harriet Kang, MD received her medical degree from The Johns Hopkins University School of Medicine where she also completed her pediatrics residency. After this, Dr. Kang completed a residency in Neurology and Child Neurology, followed by a Fellowship in clinical Neurophysiology at the University of Minnesota Hospitals. She did an additional Fellowship at the Epilepsy Research Laboratory at the Cornell University Medical Center. Prior to coming to the Mount Sinai Health System, Dr. Kang was an assistant professor of Neurology and Pediatrics and the Director of the Adult Seizure Clinic at the University of Wisconsin Hospital and Clinics, and she was the Vice President of the Wisconsin Epilepsy Association. She was the Chief of Child Neurology at Albany Medical College, and the associate director of the Comprehensive Epilepsy Management Center and chief of the pediatric neurology outpatient clinic at Montefiore Medical Center in the Bronx. She came to Beth Israel Medical Center (Now Mount Sinai Beth Israel) in 2005, and joined Mount Sinai in 2015 as a researcher and provider.
Dr. Steven Wolf and Dr. Patricia McGoldrick conducted all of their clinical research with Dr. Kang. Over the course of her impressive clinical career, Dr. Kang has also participated in numerous clinical trials and other research projects. She has been an investigator on trials for topiramate, vigabatrin, felbamate, gabapentin, oxcarbazepine, tigabine, fosphenytoin, pregabalin, cannabidiol, diazepam buccal soluble film, intranasal diazepam, inhaled alprazolam, intravenous and oral brivaracetam, perampanel, and fenfluramine.
She serves on the Board of Directors of the Epilepsy Foundation of Northeast New York and on the Advisory Council for the New York State Office for People with Developmental Disabilities. Dr. Kang has dedicated her work to improving the lives of children and adults with epilepsy, through using the best treatments available as well as seeking out investigational treatments in the hopes of better controlling the seizures of not only her patients, but all of those living with epilepsy.
Dr. Kang offers telemedicine appointments when appropriate. Please call her office to schedule a video visit.
RENYC: Rare Epilepsies in New York City: Epidemiology and Health Outcomes. Improving Surveillance with Text Processing of Clinical Notes in Electronic Health Records
The central idea of our proposal is that text processing of clinical notes will improve surveillance and epidemiology of the rare epilepsies. We will use the NYC-CDRN to identify affected individuals using EHRs from multiple academic medical centers. We will describe the incidence, prevalence, comorbidities, mortality, and quality of ambulatory care for these individuals. Finally, we will develop, characterize, and disseminate specifications for searching text (a set of "regular expressions") to find affected individuals in clinical notes.
PReventing Epilepsy using Vigabatrin in iNfants with Tuberous sclerosis complex
The study design is a Phase IIb prospective multi-center, randomized, placebo-controlled, double-blind clinical trial. The goal will be to enroll 80 infants with TSC who are less than 6 months of age prior to the onset of their first seizure. There are two hypotheses, (1) prophylactic treatment with Vigabatrin will prevent drug-resistant epilepsy in patients with TSC, and (2) Video EEG biomarkers can be found to help identify patients at risk of developing drug-resistant epilepsy.
A Retrospective Chart Review of Patients Less than 18 Years of Age at the Time of Implant with the RNS System Treated for Medically Intractable Epilepsy
Epilepsy is a common neurologic disorder of children and adolescents. One percent of children from birth to 17 years old are diagnosed with recurrent seizures. Adolescents with medically intractable partial onset seizures are at risk for poor quality of life, including psychological symptoms, and this can be lessened with better seizure control. The responsive neurostimulator (RNS) stimulator works like a pacemaker implanted in the brain. It is currently approved by the FDA as an adjunctive therapy in reducing the frequency of seizures in individuals 18 years of age and older with partial onset seizures who have undergone diagnostic testing that localized no more than 2 epileptogenic foci, are refractory to two or more antileptic medications, and currently have frequent and disabling seizures (e.g., motor partial seizures, complex partial seizures, and/or secondarily generalized seizures). The RNS system has demonstrated safety and effectiveness in patients who average 3 or more disabling seizures per month. Physicians have used the RNS system in patients younger than 18 during the course of clinical care. This study aims to use the safety and efficacy data from these patients' charts to support an expansion of the indication for use to include patients under the age of 18.
A Learning Healthcare System for Pediatric Epilepsy
The goal of this study is to create a "learning healthcare system" for pediatric epilepsy, in which clinical data are collected, analyzed, and rapidly disseminated to change practice and improve outcomes. The investigators have created a multi-centered collaborative group of pediatric epilepsy clinicians and researchers to (1) develop algorithms to identify individuals with specific sub-types of epilepsy, (2) create an active registry of children with epilepsy, (3) conduct five demonstration projects (three quality projects and two comparative effectiveness projects).
Retrospective SUDEP at Epilepsy Centers: A Case-Controlled Study
Through retrospective chart review, this study will compare cases of Sudden Unexpected Death in Epilepsy (SUDEP) against control cases to identify potential risk factors associated with SUDEP. Different epilepsy centers will participate in the study where investigators will gather information from clinical charts, EEG video and videoEEG data, brain MRI, genetic studies, EKG's and laboratory results that will allow them to identify high-risk groups. The goal of this research is to recognize patients at risk of SUDEP and start potential preventive measures that will eventually lead to greater seizure control.
A Multicenter, Open Label Crossover Study to Assess the Pharmacokinetics and Safety of Diazepam Buccal Soluble Film (DBSF) in Pediatric Subjects with Epilepsy.
Diazepam is commonly used to treat a range of conditions, including seizures. It can be administered through many routes including by mouth. This study aims to assess the use of a new route of administration in pediatric patients with epilepsy during the interictal state, and during the ictal/perictal state. The drug is approved for this population, but the new route is investigational. It is a soluble film that is placed on the inside of the mouth on the cheek. The film can be applied during a seizure, or immediately after. There have been two studies in healthy subjects to determine the amount of medication available in their blood, and one study has been done to test dose-proportionality.
An Open-Label, Safety and Tolerability Study of Chronic Intermittent Use of Diazepam Buccal Soluble Film (DBSF) in Pediatric, Adolescent and Adult Subjects with Epilepsy.
Acute repetitive seizures (ARS) including break through seizures, repetitive seizures, and seizure clusters occur in a significant number of epilepsy patients who are on established antiepileptic drug treatment. The only FDA approved treatment for ARS is Diastat Rectal Gel, a formulation of diazepam that must be administered rectally. There is a need for diazepam that can be more easily administered at home and at school for patients with ARS. This study is a phase 3 study looking at the long-term safety and tolerability of a novel route of administration of diazepam for ARS. The study drug is a soluble film that is placed inside the cheek of the subjects during ARS.
A 12-Month, Open-Label, Repeat-Dose Safety Study of NRL-1 In Epilepsy Subjects
This is an open-label study to evaluate diazepam administered into the nose for one year in subjects ages 6-65 experiencing seizure emergencies including acute repetitive seizures (ARS). ARS is definied as intermittent increases of seizure activity while on a stable regimen of antiepileptic drugs (AEDs). Diazepam given intravenously (i.e., through a vein) has been used for over 30years for the treatment of seizure emergencies, however a rectal gel formulation of diazepam called Diastat is the current standard of care. Diastat is the only diazepam formulation that is approved in the US for ARS. Due to the route of administration, the use of Diastat has been limited primarily to children ages 2-12 years. The study product, NRL-1 was previously studied in health adults and based on the results, it is estimated that diazepam exposure from the intranasal administration will be comparable to that seen in the rectal gel, but will present a more convenient route of administration for patients and caregivers.
Eisai Inc. E2007-G000-410
Multicenter, Open-Label Study to Evaluate the Efficacy and Safety of Perampanel as Monotherapy or First Adjunctive Therapy in Subjects With Partial Onset Seizures With or Without Secondarily Generalized Seizures or With Primary Generalized Tonic-Clonic Seizures.
Fycompa (perampanel) is an FDA approved add-on (adjunctive) therapy for the treatment of primary generalized tonic-clonic seizures (formerly referred to as grand mal seizures). Currently, there is limited information from clinical studies regarding the use of perampanel as a first-line therapy; however, in clinical practice, doctors routinely prescribe antiepileptic drugs (AEDs) approved for add-on (adjunctive) use as a first-line therapy (monotherapy) or withdraw other drugs until the patient is only on one drug depending on their clinical response. This study looks to assess how long subjects stay on perampanel as a first-line therapy or as a first add-on therapy for either partial onset seizures or primary generalized tonic-clonic seizures.
UCB Biopharma EP0065
A multicenter, open-label study to evaluate the pharmacokinetics, safety and tolerability of intravenous BRV in subjects ≥1 month to <16 years of age with epilepsy.
Epilepsy affects all races of both sexes at any age from the first hour of life to extreme old age. The prevalence of epilepsy is 1% to 2% of the population and 4% of pediatric population in those developed countries where they have been studied. The incidence of pediatric patients with Partial Onset Seizures (POS) is approximately 16 to 80 per 100,000. Within the pediatric population, the incidence is highest in children <5 years of age.
The existing treatment options for POS in the pediatric population generally follow the treatment options for adults with the same disorder; clinical experience demonstrates that children may have results comparable to adults with administration of the conventional antiepileptic drugs (AEDs). More than 25% of pediatric patients have inadequate seizure control on currently available AEDs or experience significant adverse drug effects. There remains a need for potent AEDs with a positive benefit-risk profile in this population.
The study drug brivaracetam (Briviact, BRV), is currently approved for the treatment of POS in ages 16 and older. The primary objective of this study is to evaluate the pharmacokinetics, safety, and tolerability of BRV administered as a 15-minute IV infusion and iv bolus (up to 2-minute infusion) in subjects ≥1 month to <16 years of age with epilepsy.
UCB Biopharma N01266
Open-label, single-arm, multicenter, long-term study to evaluate safety and efficacy of brivaracetam used as adjunctive treatment in pediatric subjects with epilepsy.
The primary objective of this study is to provide long-term safety and tolerability data on BRV in pediatric subjects with epilepsy, while providing access to BRV for subjects who may benefit from long-term treatment.
A Two-Part Study of ZX008 in Children and Adults with Lennox-Gastaut Syndrome (LGS); Part 1: A Randomized, Double-blind, Placebo-controlled Trial of Two Fixed Doses of ZX008 (Fenfluramine Hydrochloride) Oral Solution as Adjunctive Therapy for Seizures in Children and Adults with LGS, Followed by Part 2: An Open-label Extension to Assess Long-Term Safety of ZX008 in Children and Adults with LGS
This is a two part study of an investigation antiepileptic drug, fenfluramine hydrochloride (ZX008), for the adjunctive treatment of seizures in children and adults with Lennox Gastaut Syndrome. Part one of the study is a randomized, placebo controlled, double blind trial which will last for one year, and the second part is an open label safety extension which will also last for one year.
Engage E-001 StATES
This is a double blind, placebo controlled study of STAP-001 in epilepsy patients with predictable seizure patterns (i.e., patients who can reliable predict an oncoming seizure). STAP-001 is a hand-held, single-dose, single-use drug-device combination product. Oral inhalation through the product initiates the controlled rapid heating of a thin film of alprazolam to form a thermally generated, highly pure drug vapor. The vapor condenses into aerosol particles with a particle size distribution appropriate for efficient delivery to the deep lung. The rapid absorption of the drug provides peak plasma levels in the systemic circulation within minutes after administration. This method of delivery is very different from the methods used for other benzodiazepines such as intravenous lorazepam and rectal diazepam.
Ghatan SA, McGoldrick PE, Wolf SM, Kang H, and Kokoska M: “Surgical Management of Medically Refractory Epilepsy due to Early Childhood Stroke.” Journal of Neurosurgery: Pediatrics, 14(1): 58-67, 2014.
Shinnar S, Berg AT, Moshe SL, Kang H, Ballaban-Gil K, O’Dell C, Alemany M, Newstein D and Hauser WA: “What happens to children with epilepsy who experience aseizure recurrence after withdrawal of antileptic drugs?” Annals of Neurology 40: 301-302, 1996
Shinnar S, Berg AT, Moshe SL, O’Dell C, Newstein D, Kang H, Goldensohn ES and Hauser WA: “The risk of seizure recurrence following a first unprovoked afebrile seizure in childhood: An extended Follow-up.” Pediatrics 98: 216-225, 1996
Wolf S, Shinnar S, Kang H, Ballaban-Gil K, and Moshe SL: “Gabapentin toxicity in children manifesting as behavioral change.” Epilepsia 36: 1203-1205, 1995
O’Dell C, Maloney-Lutz K, Shinnar S, Ballaban-Gil K, Kang H, Lightstone L, Chester L, Sinnott M, Moshe SL: “Protocol for ACTH administration in refractory childhood seizures: Educational strategies.” Journal of Neuroscience Nursing 27: 363-369, 1995
O’Dell C, Shinnar S, Eisenberg C, Ballaban-Gil K, Lightstone L, Clements P, Maloney-Lutz K, Kang H, Legatt A, Wysznski B, Moshe SL: “Comparison of outcomes between children and adults with psychogenic seizures.” Epilepsia 36 (suppl 4): 149, 1995
Shinnar S and Kang H: “Idiosyncratic Phenobarbital toxicity mimicking a neurodegenerative disorder.” Journal of Epilepsy 7: 34-37, 1994
Shinnar S, Berg AT, Moshe SL, Kang H, O’Dell M, Goldensohn ES and Hauser WA: “Discontinuing antiepileptic drugs in children with epilepsy: A prospective study.” Annals of Neurology 35:534-545, 1994
Pelayo R, Barasch E, Kang H, Marion R, Moshe SL: “Progressively intractable seizures, focal alopecia and hemimegalencephaly.” Neurology 44(5): 969-971, 1994
Shinnar S, Berg At, Moshe SL, Kang H, Ballaban-Gil K, O’Dell c, Alemmany M, Newstein D and Hauser WA; “Long term outcomes of children with epilepsy after withdrawal of antileptic drugs.” Epilepsia 34 (suppl 8): 1994
O’Dell C, Ballaban-Gil K, Eisenberg C, Lightstone L, Clements P, Maloney-Lutz K, Kang H, Legatt A, Wysznksi B, Moshe SL and Shinnar S: “Characteristics of psychogenic seizures in children and adults.” Epilepsia 35 (suppl 8): 106, 1994
Berg AT, Steinschneider M, Kang H and Shinnar S: “Identifying complex features of febrile seizures: Medical review versus medical record review plus interview.” Journal of Epilepsy 6: 133-138, 1993
Pranzatelli MR, Kao PC, Tate ED, Chavez E, Chez M, Dobyns WB, Kang H, Rothner DA: “Antibodies to ACTH in opsoclonus-myoclonus.” Neuropediatrics 24(3): 131-133, 1993
Legatt AD, Ballaban-Gil K, Germano IM, Kang H, Shinnar S, Moshe SL: “Hippocampal spikes followed by inferior temporal spikes in patients with epilepsy of mesial temporal origin.” Neurology 43 (suppl 2): A304, 1993
Ballaban-Gil K, Shinnar S, Wolf S, Legatt A, Kang H, O’Dell C, Moshe SL: “Generalized seizures without electrographic correlate in young children.” Epilepsia 34 (suppl 6): 82, 1993
Berg AT, Steinschneider M, Kang H and Shinnar S: “Classification of complex features of febrile seizures: inter-rater agreement.” Epilepsia 33: 661-666, 1992
Shinnar S, Kang H, Berg AT, Moshe SL, Hauser WA and Goldensohn ES: “EEG Abnormalities in children with a first unprovoked seizure.” Epilepsia 31:653, 1990
Kang H and Shinnar S: “Phenobarbital toxicity presenting as a neurodegenerative syndrome.” Epilepsia 31: 682, 1990
Kang H and Shinnar S: “ Discontinuing antiepileptic drug therapy in children with epilepsy.” In Hauser, WA, editor, Current Trends in Epilepsy, 2nd edition. Epilepsy Foundation of America, Landover MD, 1988
Rubin A and Kang H: “Neurology effects of Cyclosporin A toxicity.” Neurology 37: 1072-1076, 1987
Dotson R, Dickinson L, Kang H and Dashieff R: “Effect of simultaneously ingested milk on phenytoin bioavailability.” Neurology 35: 1526-1527, 1985
Kang H and Kutt H: “Immunoassay techniques in the measurement of phenytoin levels in uremic plasma.” Clinical Chemistry 30(6):1022, 1984
Kang H and Leppik IE: “Phenytoin binding in patients undergoing renal transplantation.” Neurology 34: 83-86, 1984
Kang H and Chung RWM: “Animal models needed – Reye’s Syndrome.” Institute of Laboratory Animal Resources News 26(2): 9-10, 1983
Moore GW, Hutchins GM, Brito JC and Kang H: “Congenital malformations of the semilunar valves.” Human Pathology 11:367-372, 1980
Kang H and Mazzi E: “Apnea resulting from obstruction of the nares by an eye shield.” Journal of Pediatrics 89:652, 1976
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