Telemedicine and Epilepsy. Experience of the Central Hospital "Dr. Ignacio Morones Prieto" During and Post-pandemic COVID-19

Main Article Content

Rodolfo M. Román-Guzmán Adriana Martínez-Mayorga Arturo Gonzalez-Lara Louis D. Guzman-Martinez Jonathan Reyes-Rivera Ildefonso Rodríguez-Leyva

Abstract

Background: Telemedicine is a real-time interactive communication that enables providers to join with patients and consultants across challenging geographic distances in a cost-effective, accessible manner. Telemedicine is helpful in the treatment of epilepsy and other neurological disorders. This work aims to share the use of telemedicine in the management of patients with epilepsy belonging to suburban communities during the COVID-19 pandemic and its post-pandemic follow-up.


Material and Methods: A retrospective, descriptive, and analytical study was conducted. The Telemedicine database in our hospital underwent a retrospective analysis. The inclusion criteria encompassed patients who had an initial consultation during the confinement period (2020-2021) and had at least one videoconference in the post-confinement period (2022-2023). Various parameters, including the number of consultations received, city of origin, treatment, etiology, type of epilepsy, comorbidities, and treatment outcomes, were gathered to facilitate a comparison between the two periods. Statistical analyses were performed using IBM SPSS Statistics V.25 for Mac.


Results: Ninety-eight patients with an initial consultation between 2020 and 221 were identified, discarding 41 due to loss of follow-up during post-confinement, resulting in N=57 cases for analysis.


Conclusions: During the COVID-19 confinement period in our hospital, Telemedicine emerged as the sole feasible option for providing care to patients in remote communities. It demonstrated remarkable success in monitoring the short and midterm progression of epileptic patients. The decrease in seizure frequency was sustained during the midterm.

Keywords: Telemedicine, focal seizures, generalized seizures, epilepsy, antiseizure drugs

Article Details

How to Cite
ROMÁN-GUZMÁN, Rodolfo M. et al. Telemedicine and Epilepsy. Experience of the Central Hospital "Dr. Ignacio Morones Prieto" During and Post-pandemic COVID-19. Medical Research Archives, [S.l.], v. 12, n. 4, apr. 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5274>. Date accessed: 09 oct. 2024. doi: https://doi.org/10.18103/mra.v12i4.5274.
Section
Research Articles

References

1. Moghadas A, Jamshidi M, Shaderam M. Telemedicine in healthcare system. In: IEEE; 2008:1-6.

2. Haleem A, Javaid M, Singh RP, Suman R. Telemedicine for healthcare: Capabilities, features, barriers, and applications. Sens Int. 2021;2:100117.

3. Barbosa W, Zhou K, Waddell E, Myers T, Dorsey ER. Improving Access to Care: Telemedicine Across Medical Domains. Annu Rev Public Health. 2021;42(1):463-481. doi:1 0.1146/annurev-publhealth-090519-093711

4. Velasquez SE, Chaves-Carballo E, Nelson EL. Pediatric Teleneurology: A Model of Epilepsy Care for Rural Populations. Pediatr Neurol. 2016;64:32-37. doi:10.1016/j.pediatr neurol.2016.08.001

5. Al Kasab S, Almallouhi E, Holmstedt CA. Optimizing the Use Of Teleneurology During the COVID-19 Pandemic. Telemed E-Health. 2020;26(10):1197-1198. doi:10.1089/tmj.2020.0109

6. Rathore C, Baheti N, Bansal AR, et al. Impact of COVID-19 pandemic on epilepsy practice in India: A tripartite survey. Seizure. 2021;86:60-67.

7. Borghs S, Beaty S, Parekh W, Kalilani L, Boudiaf N, Loewendorf A. Cost of epilepsy-related health care encounters in the United States. J Manag Care Spec Pharm. 2020;26(12 ):1576-1581. doi:10.18553/jmcp.2020.20111

8. Wechsler LR, Tsao JW, Levine SR, et al. Teleneurology applications: Report of the Telemedicine Work Group of the American Academy of Neurology. Neurology. 2013;80( 7):670-676. doi:10.1212/WNL.0b013e3182823361

9. Wechsler LR. Advantages and Limitations of Teleneurology. JAMA Neurol. 2015;72(3):3 49. doi:10.1001/jamaneurol.2014.3844

10. Flumignan CDQ, Rocha AP da, Pinto ACPN, et al. What do Cochrane systematic reviews say about telemedicine for healthcare? Sao Paulo Med J. 2019;137:184-192.

11. Rasmusson KA, Hartshorn JC. A Comparison of Epilepsy Patients in a Traditional Ambulatory Clinic and a Telemedicine Clinic. Epilepsia. 2005;46(5):76 7-770. doi:10.1111/j.1528-1167.2005.44804.x

12. Haddad N, Grant I, Eswaran H. Telemedicine for patients with epilepsy: A pilot experience. Epilepsy Behav. 2015;44:1-4. doi:10.1016/j.yebeh.2014.11.033

13. Kissani N, Lengané YTM, Patterson V, et al. Telemedicine in epilepsy: How can we improve care, teaching, and awareness? Epilepsy Behav. 2020;103:106854. doi:10.101 6/j.yebeh.2019.106854

14. Licchetta L, Trivisano M, Baldin E, et al. TELEmedicine for EPIlepsy Care (TELE-EPIC): protocol of a randomised, open controlled non-inferiority clinical trial. BMJ Open. 2021; 11(12):e053980.

15. Banks J, Corrigan D, Grogan R, et al. LoVE in a time of CoVID: Clinician and patient experience using telemedicine for chronic epilepsy management. Epilepsy Behav. 2021; 115:107675. doi:10.1016/j.yebeh.2020.107675

16. Zuberi SM, Wirrell E, Yozawitz E, et al. ILAE classification and definition of epilepsy syndromes with onset in neonates and infants: Position statement by the ILAE Task Force on Nosology and Definitions. Epilepsia. 2022;63( 6):1349-1397.

17. Falco-Walter J. Epilepsy—definition, classification, pathophysiology, and epidemiology. In: Vol 40. Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY …; 2020:617-623.

18. Falco-Walter JJ, Scheffer IE, Fisher RS. The new definition and classification of seizures and epilepsy. Epilepsy Res. 2018;139 :73-79.

19. Bhalla D, Godet B, Druet-Cabanac M, Preux PM. Etiologies of epilepsy: a comprehensive review. Expert Rev Neurother. 2011;11(6):861-876.

20. Patel P, Moshé SL. The evolution of the concepts of seizures and epilepsy: What’s in a name? Epilepsia Open. 2020;5(1):22-35.

21. Van Mierlo P, Vorderwülbecke BJ, Staljanssens W, Seeck M, Vulliémoz S. Ictal EEG source localization in focal epilepsy: Review and future perspectives. Clin Neurophysiol. 2020;131(11):2600-2616.

22. Goodman AM, Szaflarski JP. Recent advances in neuroimaging of epilepsy. Neurotherapeutics. 2021;18(2):811-826.

23. Perucca E. The pharmacological treatment of epilepsy: recent advances and future perspectives. Acta Epileptol. 2021;3(1):22.

24. Hauser WA, Annegers JF, Kurland LT. Incidence of epilepsy and unprovoked seizures in Rochester, Minnesota: 1935–1984. Epilepsia. 1993;34(3):453-458.

25. Liu G, Slater N, Perkins A. Epilepsy: treatment options. Am Fam Physician. 2017;9 6(2):87-96.

26. Josephson CB, Jetté N. Psychiatric comorbidities in epilepsy. Int Rev Psychiatry. 2017;29(5):409-424.

27. Salpekar JA, Mula M. Common psychiatric comorbidities in epilepsy: How big of a problem is it? Epilepsy Behav. 2019;98:29 3-297.

28. Xiao Z, Ding D, Li S, Hong Z. Management of people with epilepsy during the COVID-19 pandemic: a national survey among epileptologists in China. Acta Epileptol. 2020;2(1):1-7.

29. Andraus M, Thorpe J, Tai XY, et al. Impact of the COVID-19 pandemic on people with epilepsy: findings from the Brazilian arm of the COV-E study. Epilepsy Behav. 2021;123:108261.

30. Mostacci B, Licchetta L, Cacciavillani C, et al. The impact of the COVID-19 pandemic on people with epilepsy. An Italian survey and a global perspective. Front Neurol. 2020;11:61 3719.