Pushing boundaries for developmental and epileptic encephalopathy, with Olivia Kim-McManus, MD

Following our previous coverage of key pediatric neurology conversations at the 2025 Child Neurology Society (CNS) Annual Meeting in Charlotte, another critical discussion centered on improving care for children with developmental and epileptic encephalopathies (DEEs). In our second conversation, Olivia Kim-McManus, MD, a child neurologist at Rady Children’s Hospital–San Diego, expanded on the unique and often complex profiles of children with DEEs and the evolving clinical approach needed to support them.

“That’s a group that can be very heterogeneous. But there are a lot of overlapping symptoms; these can be seizures, developmental delay, autism, movement disorders,” she said. “And so these are things that, as a group, are different. It’s different from having one seizure.”

WATCH: Olivia Kim-McManus, MD, discusses genetic testing, therapy in pediatric neurology²

Because these children often require multidisciplinary involvement—including nutritional support, mobility assistance, or care related to cerebral palsy—Kim-McManus emphasized the importance of building a strong, coordinated care network. “There are lots of complexities that come with children who also need other systems of care, including G-tube feedings or maybe cerebral palsy and things like that.”

Her message throughout the session centered on possibility—avoiding assumptions about a child’s limitations and instead pushing expectations forward.

“You never know what a child might or might not be able to do. You never know the boundaries, and we keep pushing the boundaries because, you know, I’ve heard ‘it’s not possible,’ and you don’t want to think that in a child. I’ve had so many times where I’ve been in a room and someone assumes that a nonverbal child can’t communicate, but I have had so many kids who have hilarious conversations on text-based, assistive communication devices, saying things to me like ‘you’re ridiculous,’ and I love that.”

Kim-McManus concluded with a message applicable to clinicians, caregivers, and families alike: “Let’s just optimize for each child, and you don’t know exactly where the boundaries are, and we keep pushing.”

References:

1. Kim-McManus O. A Pathway from Genetic Diagnosis to Targeted Genetic Therapy. Session. Presented at: 2025 Child Neurology Society Annual Meeting. October 8-11, 2025. Charlotte, North Carolina.
2. Fitch J. Olivia Kim-McManus, MD, discusses genetic testing, therapy in pediatric neurology. Contemporary Pediatrics. Published November 17, 2025. Accessed November 18, 2025. https://www.contemporarypediatrics.com/view/olivia-kim-mcmanus-discusses-genetic-testing-therapy-in-pediatric-neurology