Niels L. Low, MD (1916-2007)

Niels L. Low, a long-term colleague and friend and one of the pioneers in child neurology, was born in Copenhagen, Denmark, on December 16, 1916, the third generation of a family of physicians. He attended the medical school of Charles University in Prague, transferring for his last year to the Medical College of South Carolina, Charleston, from which he graduated in 1940. A rotating internship in Racine, Wisc, from 1940 to 1941 was followed by 2 years of pediatric residency at Milwaukee Children’s Hospital. It was while he was performing a spinal tap on an infant that he met a charming rotating student nurse, Mary Margaret, who was holding down the child and would become his wife of 64 years.

Niels L. Low at his 90th birthday celebration in December 2006.During World War II, Niels served in the United States Army in England, Belgium, and France and was discharged with the rank of Captain in 1946. He entered pediatric practice in Racine until 1953, during which time he was in charge of the epilepsy clinic and electroencephalography (EEG) at the Milwaukee Children’s Hospital. He then moved as research fellow to Chicago, Ill, to receive formal training in EEG under Dr Frederick Gibbs, the father of clinical EEG, with whom he wrote 2 papers on childhood EEGs.

His next move, in 1955, was to The Neurological Institute of New York at Columbia– Presbyterian Medical Center for a 1-year United Cerebral Palsy Fellowship under the mentorship of Dr Sidney Carter. Armed with these new skills, he was recruited by Dr James F. Bosma to the University of Utah Medical School as Associate Research Professor of Pediatrics. This is where he was exposed to the severe consequences of untreated phenylketonuria and to a variety of other neurologic illnesses of childhood.

Determined to become a card-carrying child neurologist, Niels returned in 1958 to The Neurological Institute as an NIH-supported trainee to complete 2 more years of fellowship, including the year of adult neurology, that would make him eligible to sit for the American Board of Psychiatry and Neurology exami- nation, which he easily passed in December 1960, after walking several miles in a blizzard from his house in New Jersey to The Neurological Institute.

Dr Carter, impressed by the unique talents displayed by Niels both as a clinician and as a teacher, invited him to join the Columbia University faculty where he climbed through the ranks, being appointed Professor of Clinical Neurology and Pediatrics in 1989. He was in charge of the very active child neurology clinic, made teaching rounds, and took care of patients. Deeply interested in the care of handicapped children, Niels, Dr Carter, and other child neurologists from The Neurological Institute regularly went to Blythedale Children’s Hospital to consult on those with cerebral palsy and other chronic illnesses.

Often they invited trainees, stu- dents, and any others with an afternoon to spare to come with them. His services were so much appreciated that Blythedale Children’s Hospital appointed him to the staff and embraced him as Medical Director and Chief of Pediatrics for the 8 years that followed his mandatory retire- ment at age 65 years from Columbia–Presbyterian Medical Center. Indefatigable, he then joined part time a group of colleagues for a few more years to continue caring for chil-dren with neurological illnesses.

His many trainees universally remember him as an out- standing clinician, a no-nonsense teacher, and kind to and caring of children and their parents. He was an early and dogged champion of the use of corticosteroids to treat infants with infantile spasms, one of his enduring interests. At a time when child neurology was a new specialty focused on exotic diseases, Niels concern was chronic disorders and their consequences for children’s lives. He wrote, in collabo- ration with the physiatrist Dr James Downey, The Child With Disabling Illness, which went through 2 editions. He was also the author of some 2 dozen papers and chapters, and he lectured widely in the United States and abroad.

He was very active in national and international pediatric, neurologic, and child neurology societies, and was elected early, in 1965, to active membership of the American Neurological Association, the senior academic neurologic society. He served on the boards of both the American EEG Society and the International Child Neurology Association, of which he was a founding member and its second presi- dent (1975-1979).

Niels had many outside interests: he liked gardening, history, stamp collecting, and travel. Above all, his 2 enduring loves were his family,his wife, 2 highly accomplished children, 5 grandchildren, and 1 great grandson and child neurology. Instantly recognizable (Figure 1) by his bow tie, spare and erect silhouette, and the patch to cover the eye he lost to cancer more than 30 years ago, his many friends and colleagues and his innumerable trainees and students all miss his forthrightness and no-nonsense approach to prob- lems, dry wit, remarkable clinical acumen, and unfailing kindness. He died quietly at home in Tenafly, New Jersey, on August 29, 2007.

Bibliography of Niels L. Low

1. Gibbs FA, Low NL. Electroencephalography in children. Pediatr Clin North Am. 1955;Feb, Vol. 2:291-303.
2. Low NL, Gibbs EL, Gibbs FA. Electroencephalographic findings in breath holding spells. Pediatrics. 1955;15:595-599.
3. Low NL. Electroencephalographic studies following pertussis immunizations. J Pediatr. 1955;47:35-39.
4. Low NL, Carter S. Multiple sclerosis in children. Pediatrics. 1956;18:24-30.
5. Low NL, Scheinberg L, Andersen DH. Brain tissue in the nose and throat. Pediatrics. 1956;18:254-259.
6. Armstrong MD, Carlisle JW, Low NL. Phenylketonuria; two unusual cases. Lancet. 1956;271(6949):917-918.
7. Low NL, Bosma JF, Armstrong MD. Studies on phenylketonuria. VI. EEG studies in phenylketonuria. AMA Arch Neurol Psychiatry. 1957;77:359-365.
8. Armstrong MD, Low NL. Phenylketonuria VIII. Relation between age, serum phenylalanine level, and phenylpyruvic acid excre- tion. Proc Soc Exp Biol Med. 1957;94:142-146.
9. Armstrong MD, Low NL, Bosma JF. Studies on phenylketonuria. IX. Further observations on the effect of phenylalanine- restricted diet on patients with phenylketonuria. Am J Clin Nutr. 1957;5:543-554.
10. Low NL, Myers GG. Suvren in brain-injured children. J Pediatr. 1958;52:259-263.
11. Low NL, Schneider J, Carter S. Polyneuritis in children. Pediatrics. 1958;22:972-990.
12. Low NL, Bosma JF, Armstrong MD, Madsen JA. Infantile spasms with mental retardation. I. Clinical observations and dietary experiments. Pediatrics. 1958;22:1153-1164.
13. Low NL. Infantile spasms with mental retardation. II. Treatment with cortisone and adrenocorticotropin. Pediatrics. 1958;22: 1165-1169.
14. Low NL. Infantile spasms. Pediatr Clin North Am. 1960 May;7:373-380. 
15. Low NL, Yahr MD. The lack of pulmonary fibrosis in patients receiving diphenylhydantoin. JAMA. 1960;174:1201-1202. 
16. Poser CM, Low NL. Autopsy findings in three cases of hypsarhythmia (infantile spasms with mental retardation). Acta Paediatr.1960;49:695-706. 
17. Low NL, Dawson SP. Electroencephalographic findings in juvenile delinquency. Pediatrics. 1961;28:452-457. 
18. Fois A. The Electroencephalogram of the Normal Child. Translated and edited by Niels L. Low. Springfield, IL: C. C. Thomas; 1961. 
19. Low NL, Carter S. Paediatric neurology. Dev Med Child Neurol.1963;18:412-415. 
20. Low NL, Correll JW, Hammill JF. Tumors of the cerebral hemispheres in children. Arch Neurol. 1965;13:547-554. Low NL, Correll JW. Head pain due to leptomeningeal cysts. Br J Surg. 1966;53:791-793. 
21. Chutorian AM, Gold AP, Low NL. Steroid therapy of non-infantile (childhood) myoclonic epilepsy. Neurology. 1968;18:304-305. Low NL. Cerebral palsy. Med Clin North Am. 1972;56:1273-1279. 
22. Downey JA, Low NL, eds. The Child With Disabling Illness;Principles of Rehabilitation. Philadelphia: W. B. Saunders;1974; 2nd ed. New York: Raven Press; 1982. 
23. Low NL. Spinal muscular atrophy syndromes. Pediatr Ann.1977;6:162-168. 
24. Low NL. A hypothesis why “early intervention” in cerebral palsy might be useful. Brain Dev. 1980;2:133-135. 
25. Jankovic J, Armstrong D, Low NL, Goetz CG. Case 2, 1988.Congenital mental retardation and juvenile parkinsonism. MovDisord. 1988;3:352-361. 
26. Jankovic J, Armstrong D, Low NL, Rapin I. Case 3, 1988. Progressive myoclonic epilepsy, dementia, and blindness in a young girl. Mov Disord. 1988;3:362-369.

Original article: 

In Memoriam: Niels L. Low, MD (1916-2007)

Arnold P. Gold and Isabelle Rapin J Child Neurol 2008 23: 468