CAP Profiles

Bio

Bio

Dr. Kvam is a board-certified neurologist and fellowship-trained neurohospitalist, specializing in the care of patients with a variety of acute neurological disorders including headache, epilepsy, Guillain-Barre, myasthenia gravis, encephalitis, multiple sclerosis and other neuroinflammatory diseases as well as neurologic complications of systemic disease.

She is the founding director of the Stanford Neurohospitalist Program and spends most of her time attending on the neurohospitalist ward and consult services. She is actively involved in teaching medical students, residents and fellows. Dr. Kvam also helps co-direct the Neurology Resident Safety, Quality & Improvement Curriculum and has led a number of quality improvement initiatives on the inpatient neurology service. Her research interests include improving the quality and value of care for hospitalized neurology patients, transitions of care, postacute care of encephalitis, and resident and interprofessional education.

For more information about our Stanford Neurohospitalist Program, please visit our website: https://med.stanford.edu/neurology/divisions/neurohospitalist.html

Academic Appointments

Administrative Appointments

  • Director, Stanford Neurohospitalist Program (2014 - Present)

Honors & Awards

  • Lysia K. Forno Award for Excellence in Teaching Neurology Residents, Stanford Department of Neurology (2018)
  • Excellence in Neurology Clerkship Teaching Award, Stanford Department of Neurology (2018)
  • Excellence in Neurology Clerkship Teaching Award, Stanford Department of Neurology (2017)
  • Excellence in Neurology Clerkship Teaching Award, Stanford Department of Neurology (2015)

Boards, Advisory Committees, Professional Organizations

  • Member, AAN Evidence Based Quality Measures Committee (2018 - Present)
  • Chair, H1 Unit RN-MD Committee (2016 - 2018)
  • Member, Stanford Neurology Clinical Competencies Committee (2017 - Present)
  • Member, Stanford Neurology Education Committee (2015 - Present)
  • Member, Stanford Neurology Professional Practice Committee (2014 - Present)
  • Member, International Encephalitis Consortium (2014 - Present)
  • Member, American Academy of Neurology (2010 - Present)
  • Member, Society of Hospital Medicine (2016 - Present)
  • Member, Neurohospitalist Society (2013 - Present)

Professional Education

  • Board Certification, American Board of Psychiatry & Neurology (2013)
  • Fellowship, University of California, San Francisco, Neurohospitalist (2014)
  • Residency, University of California, San Francisco, Neurology (2013)
  • Internship, St. Joseph Mercy Medical Center, Internal Medicine (2010)
  • MD, University of Michigan (2009)
  • B.S. Economics, University of Pennsylvania, Health Care Management & Chemistry (2002)

Community and International Work

  • English Teacher, Mongolia

    Partnering Organization(s)

    Peace Corps

    Location

    International

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

Links

Research & Scholarship

Current Research and Scholarly Interests

Dr. Kvam's research focuses on how to optimize patient-centered care, patient outcomes and organize systems of care.

Publications

All Publications

  • Yield of Emergent CT in Patients With Epilepsy Presenting With a Seizure NEUROHOSPITALIST Kvam, K. A., Douglas, V. C., Whetstone, W. D., Josephson, S., Betjemann, J. P. 2019; 9 (2): 71–78

    Abstract

    Studies of emergent neuroimaging in the management of patients presenting with a breakthrough seizure are lacking. We sought to determine how often emergent computed tomography (CT) scans are obtained in patients with known epilepsy presenting with a seizure and how often acute abnormalities are found.This multicenter retrospective cohort study was performed in the emergency department at 2 academic medical centers. The primary outcomes were percentage of visits where a CT scan was obtained, whether CT findings represented acute abnormalities, and whether these findings changed acute management.Of the 396 visits included, CT scans were obtained in 39%, and 8% of these scans demonstrated acute abnormalities. Patients who were older, had status epilepticus, a brain tumor, head trauma, or an abnormal examination were all significantly more likely to undergo acute neuroimaging (P < .05). In the multivariable model, only history of brain tumor (odds ratio [OR] 5.88, 95% confidence interval [CI], 1.33-26.1) and head trauma as a result of seizure (OR 3.92, 95% CI, 1.01-15.2) reached statistical significance in predicting an acutely abnormal scan. The likelihood of an acute imaging abnormality in visits for patients without a history of brain tumor or head trauma as a result of the seizure was 2.7% (2 visits). Both of these patients had abnormal neurological examinations.Obtaining an emergent CT scan for patients with epilepsy presenting with a seizure may be avoidable in most cases, but might be indicated for patients with a history of brain tumor or head trauma as a result of seizure.

    View details for DOI 10.1177/1941874418808676

    View details for Web of Science ID 000461771400004

    View details for PubMedID 30915184

    View details for PubMedCentralID PMC6429671

  • A Quality Improvement Curriculum for Neurology Residents Miller-Kuhlmann, R., Kraler, L., Bozinov, N., Frolov, A., Mlynash, M., Gold, C., Kvam, K. LIPPINCOTT WILLIAMS & WILKINS. 2018

    View details for Web of Science ID 000453090805218

  • A case of progressive multifocal leukoencephalopathy in a lupus patient treated with belimumab LUPUS Fredericks, C. A., Kvam, K. A., Bear, J., CRABTREE, G. S., Josephson, S. A. 2014; 23 (7): 711-713

    Abstract

    Belimumab is a monoclonal antibody against soluble B-lymphocyte stimulator, an essential growth factor for B-cell maturation and activation, which was approved by the US FDA in 2011 for patients with active autoantibody-positive systemic lupus erythematosus (SLE) who have failed standard treatment. Here we present the case of a 40-year-old woman with SLE diagnosed with progressive multifocal leukoencephalopathy (PML) on belimumab. After a total of 10 infusions of belimumab, from August 2012 through April 2013, in April 2013 she developed progressive neurologic decline with episodic dystonia and autonomic symptoms. Her imaging showed multifocal, confluent regions of T2 hyperintensity in the white matter bilaterally, and CSF JCV PCR returned positive. Based on the patient's clinically mild SLE and the timing of symptom onset, belimumab likely played a key role in the development of PML. Trials of belimumab for other autoimmune diseases are ongoing; as applications for this novel drug broaden, careful monitoring for this potentially fatal adverse effect is warranted.

    View details for DOI 10.1177/0961203314524292

    View details for Web of Science ID 000339103900015

    View details for PubMedID 24531080

  • Sedation with nitrous oxide compared with no sedation during catheterization for urologic imaging in children. Pediatric radiology Zier, J. L., Kvam, K. A., Kurachek, S. C., Finkelstein, M. 2007; 37 (7): 678–84

    Abstract

    Various strategies to mitigate children's distress during voiding cystourethrography (VCUG) have been described. Sedation with nitrous oxide is comparable to that with oral midazolam for VCUG, but a side-by-side comparison of nitrous oxide sedation and routine care is lacking.The effects of sedation/analgesia using 70% nitrous oxide and routine care for VCUG and radionuclide cystography (RNC) were compared.A sample of 204 children 4-18 years of age scheduled for VCUG or RNC with sedation or routine care were enrolled in this prospective study. Nitrous oxide/oxygen (70%/30%) was administered during urethral catheterization to children in the sedated group. The outcomes recorded included observed distress using the Brief Behavioral Distress Score, self-reported pain, and time in department.The study included 204 patients (99 nonsedated, 105 sedated) with a median age of 6.3 years (range 4.0-15.2 years). Distress and pain scores were greater in nonsedated than in sedated patients (P < 0.001). Time in department was longer in the sedated group (90 min vs. 30 min); however, time from entry to catheterization in a non-imaging area accounted for most of the difference. There was no difference in radiologic imaging time.Sedation with nitrous oxide is effective in reducing distress and pain during catheterization for VCUG or RNC in children.

    View details for DOI 10.1007/s00247-007-0508-z

    View details for PubMedID 17564739