Emergency implementation of telemedicine for epilepsy in Spain: Results of a survey during SARS-CoV-2 pandemic

Abstract

Teleneurology in Spain had not been implemented so far in clinical practice, except in urgent patients with stroke. Telemedicine was hardly used in epilepsy, and patients and neurologists usually preferred onsite visits. Our goal was to study impressions of adult and pediatric epileptologists about the use of telemedicine after emergent implementation during the new coronavirus 2019 (COVID-19) pandemic. Methods: An online survey was sent to the members of the Spanish Epilepsy Society and the members of the Epilepsy Study Group of the Catalan Neurological Society, inquiring about different aspects of telemedicine in epilepsy during the pandemic lockdown. Results: A total of 66 neurologists responded, mostly adult neurologists (80.3%), the majority with a monographic epilepsy clinic (4 out of 5). Of all respondents, 59.1% reported to attend more than 20 patients with epilepsy (PWE) a week. During the pandemic, respondents handled their epilepsy clinics mainly with telephone calls (88%); only 4.5% used videoconference. Changes in antiseizure medications were performed less frequently than during onsite visits by 66.6% of the epileptologists. Scales were not administered during these visits, and certain types of information such as sudden expected unrelated death in epilepsy (SUDEP) were felt to be more appropriate to discuss in person. More than 4 out of 5 of the neurologists (84.8%) stated that they would be open to perform some telematic visits in the future. Conclusions: In Spain, emergent implantation of teleneurology has shown to be appropriate for the care of many PWE. Technical improvements, extended use of videoconference and patient selection may improve results and patient and physician satisfaction.

COVID-19, de novo seizures, and epilepsy: a systematic review

“…One observational comparative study confirmed that PWE showed more psychological distress than healthy controls, and they spent significantly more time following the COVID-19 outbreak news [13]. Finally, four studies showed that telemedicine may improve access to specialized care for PWE in these difficult times [10,[20][21][22]. The development of an epilepsy electronic patient portal may promote improved patient-clinician partnerships and facilitate patient self-management [23] 1.2.…”

Doctors race to understand epilepsy in the time of COVID-19

“…. Considering this last aspect, the SARS-CoV-2 crisis has obliged physicians to adopt telemedicine in a very accelerated way to maintain essential care for patients with epilepsy during the pandemic [11,12]. On the other hand, the discussion about SUDEP and the possibility of the occurrence of a greater number of cases of premature death among individuals with epilepsy has not been receiving special attention during application of telehealth.…”

“…Thus, an interesting recent study evaluated experiences of adult and pediatric epileptologists about the use of telemedicine after emergent implementation during the new SARS-CoV-2 pandemic. In brief, the authors clearly demonstrated that certain topics, such as SUDEP, were felt to be more appropriate to discuss face to face [11].…”

“…Thus, the neurological implications of SARS-CoV-2 infection have received special attention [ 3 ], and neuroscientists have established consensus recommendations on how to provide the best possible care for people with epilepsy during the novel coronavirus 2019 era [ 1 , [7] , [8] , [9] , [10] ]. In this context, although the medical team's first reaction was to limit access to clinics and neurological centers to preserve patients with epilepsy from being infected [ 10 ], some interesting proposals regarding healthcare facilities logistics, medical procedures and treatment (ensuring a regular supply of antiepileptic drugs), and telemedicine have also been discussed among various epileptologists operating in different regions of the world [ 4 , [7] , [8] , [9] , [10] , [11] ]. Considering this last aspect, the SARS-CoV-2 crisis has obliged physicians to adopt telemedicine in a very accelerated way to maintain essential care for patients with epilepsy during the pandemic [ 11 , 12 ].…”

“…In this context, although the medical team's first reaction was to limit access to clinics and neurological centers to preserve patients with epilepsy from being infected [ 10 ], some interesting proposals regarding healthcare facilities logistics, medical procedures and treatment (ensuring a regular supply of antiepileptic drugs), and telemedicine have also been discussed among various epileptologists operating in different regions of the world [ 4 , [7] , [8] , [9] , [10] , [11] ]. Considering this last aspect, the SARS-CoV-2 crisis has obliged physicians to adopt telemedicine in a very accelerated way to maintain essential care for patients with epilepsy during the pandemic [ 11 , 12 ]. On the other hand, the discussion about SUDEP and the possibility of the occurrence of a greater number of cases of premature death among individuals with epilepsy has not been receiving special attention during application of telehealth.…”