Telemedicine in a pediatric headache clinic

Qubty, William; Patniyot, Irene; Gelfand, Amy A.

doi:10.1212/wnl.0000000000005482

Cited by 58 publications

(80 citation statements)

References 11 publications

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“…Hence, a constant update of clinicians is required. Finally, due to the need of carefully monitoring their patients, child neurology specialists should consider that a helpful tool might be represented by telemedicine, which has been proven to obtain similar satisfaction rates and eventual outcomes compared with traditional visit for different diseases [52][53][54].…”

Section: Impact Of Covid-19 In Patients With Chronic Neurological Dismentioning

confidence: 99%

Challenges and management of neurological and psychiatric manifestations in SARS-CoV-2 (COVID-19) patients

et al. 2020

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COVID-19 is a pandemic caused by human coronavirus (HCoV) SARS-CoV-2, which originated in Wuhan, China, at the end of 2019 and spread globally during 2020. Due to the difficulty of clinical decision-making during this period, our study group reviewed current literature focusing on the neurological and psychiatric aspects of COVID-19. Despite the knowledge on this newly discovered virus which is constantly evolving, different pieces of evidence reported an association between COVID-19 and neurological symptoms like headache, dizziness, taste and smell disorders and complications involving the nervous system eventually triggered by the pathologic processes elicited by SARS-CoV-2. It seems that younger patients are less prone to develop severe forms of COVID-19. However, neurological signs have been reported in paediatric patients as well, and in some cases, the infection presented neurological sequelae. Furthermore, children with particular neurological diseases or treated with specific drugs (e.g. immune-suppressant therapies) must be carefully monitored during this pandemic. Neurologists should be aware of the main drug-drug interactions and the neurological side effects of COVID-19 treatments. Notably, adverse mental health impact has been reported in patients with SARS-CoV-2, which could be related either to the social strain or to the eventual neurotropic effects of the virus, which in other infections have been proven to promote the onset of psychiatric symptoms. Further, psychiatric population may be more vulnerable to the infection and at higher risk for adverse outcomes.

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Section: Impact Of Covid-19 In Patients With Chronic Neurological Dismentioning

confidence: 99%

Challenges and management of neurological and psychiatric manifestations in SARS-CoV-2 (COVID-19) patients

et al. 2020

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“…In 2017, 1 randomized trial found telemedicine consultations for nonacute headache to be as efficient and safe as traditional consultation 32 . A pediatric headache clinic’s prospective analysis from 2018 similarly showed telemedicine to be convenient, cost‐effective, and patient‐centered, thereby providing high patient and family satisfaction for routine follow‐up visits 33 . Further, in 1 randomized cohort of patients with severe migraine‐related disability, telemedicine proved a feasible and effective mode of treatment when compared to in‐office visits for migraine follow‐up care 34 .…”

Section: Impact Of Covid‐19 On Patients With Headache Disorders and Omentioning

confidence: 99%

COVID‐19 and Headache: A Primer for Trainees

Bobker

Robbins

2020

Headache

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Objective To summarize for the trainee audience the possible mechanisms of headache in patients with COVID‐19 as well as to outline the impact of the pandemic on patients with headache disorders and headache medicine in clinical practice. Background COVID‐19 is a global pandemic caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2, of which a large subset of patients features neurological symptoms, commonly headache. The virus is highly contagious and is, therefore, changing clinical practice by forcing limitations on in‐person visits and procedural treatments, more quickly shifting toward the widespread adaptation of telemedicine services. Design/Results We review what is currently known about the pathophysiology of COVID‐19 and how it relates to possible mechanisms of headache, including indirect, potential direct, and secondary causes. Alternative options for the treatment of patients with headache disorders and the use of telemedicine are also explored. Conclusions Limited information exists regarding the mechanisms and timing of headache in patients with COVID‐19, though causes relate to plausible direct viral invasion of the nervous system as well as the cytokine release syndrome. Though headache care in the COVID‐19 era requires alterations, the improved preventive treatment options now available and evidence for feasibility and safety of telemedicine well positions clinicians to take care of such patients, especially in the COVID‐19 epicenter of New York City.

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“…Telemedicine, which is real time interactive audio and video remote communication between a patient and a provider, has been practiced for over a decade in the United States. Single clinic studies of telemedicine visits for headache care have demonstrated that patients perceive telemedicine as cost‐effective and convenient 7 . Compared to traditional in‐person headache visits, telemedicine achieves similar satisfaction rates 8 and outcomes, 9 and recent investigations demonstrated non‐inferiority in multiple neurological diseases 10 .…”

Section: Introductionmentioning

confidence: 99%

Migraine Care in the Era of COVID‐19: Clinical Pearls and Plea to Insurers

et al. 2020

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Objective.-To outline strategies for the treatment of migraine which do not require in-person visits to clinic or the emergency department, and to describe ways that health insurance companies can remove barriers to quality care for migraine.Background.-COVID-19 is a global pandemic causing widespread infections and death. To control the spread of infection we are called to observe "social distancing" and we have been asked to postpone any procedures which are not essential. Since procedural therapies are a mainstay of headache care, the inability to do procedures could negatively affect our patients with migraine. In this manuscript we review alternative therapies, with particular attention to those which may be contra-indicated in the setting of COVID-19 infection.Design/Results.-The manuscript reviews the use of telemedicine visits and acute, bridge, and preventive therapies for migraine. We focus on evidence-based treatment where possible, but also describe "real world" strategies which may be tried. In each section we call out areas where changes to rules from commercial health insurance companies would facilitate better migraine care.Conclusions.-Our common goal as health care providers is to maximize the health and safety of our patients. Successful management of migraine with avoidance of in-person clinic and emergency department visits further benefits the current urgent societal goal of maintaining social distance to contain the COVID-19 pandemic.

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Telemedicine in a pediatric headache clinic

Abstract: This prospective, pediatric headache telemedicine study shows that telemedicine is convenient, perceived to be cost-effective, and patient-centered. Providing the option of telemedicine for routine pediatric headache follow-up visits results in high patient and family satisfaction.

Cited by 58 publications

References 11 publications

Challenges and management of neurological and psychiatric manifestations in SARS-CoV-2 (COVID-19) patients

Challenges and management of neurological and psychiatric manifestations in SARS-CoV-2 (COVID-19) patients

COVID‐19 and Headache: A Primer for Trainees

Migraine Care in the Era of COVID‐19: Clinical Pearls and Plea to Insurers

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