Rethinking Seizure Care Blog

Can Teleconsultation Prove Effective for Children with Epilepsy?

Posted by RSC Diagnostics on Sep 9, 2020

 

Portrait of confident female doctor using telephone at desk in clinic

It does not matter where you are; in this current era, you are in a country in which the COVID-19 pandemic has made major changes in many areas of life. From education to the workplace, the pandemic has made handling "everyday" issues a challenge, and put even more difficulty in the more unique needs. As a prime example of this, consider the emergence of telemedicine.

Telemedicine, according to one definition, “refers to the practice of caring for patients remotely when the provider and patient are not physically present with each other. Modern technology has enabled doctors to consult patients” via video conferencing tools of many kinds.

Yet, many wonder whether it is effective for all medical requirements? A recent article from Seizure posed the question of whether telemedicine can be effective in treating epilepsy, particularly in resource-limited countries.

Questions and Answers

The article sought to determine whether telemedicine can “act as a feasible and effective option in children with epilepsy during pandemic situations,” and if so, just what that should look like.

Noting that the COVID-19 pandemic has put entire countries into lockdown conditions, and this has “forced neurologists across the world to look upon telemedicine as the only feasible and practical option to continue providing health care towards children with epilepsy in home isolation.”

Naturally, this is a challenging scenario because a child is not often able to report full data and may be unable to properly explain or fully display the effects of the condition. However, as the only resource at such times, it has to be studied and considered.

Methods and Findings

The research noted in the report looked at telephone consultations from March through May 2020 in a hospital in “Uttarakhand (a state of India known for hilly terrains with low per capita income)." Using text messaging, picture/video messaging, voice calls, and any other available resources, physicians attempted to gather as much clinical data on each patient as possible.

Through this approach, they were able to change dosages in AED (anti-epileptic drug) regimens, as well as add new AEDs, when needed. There were also instances of referrals to local healthcare providers or hospitals when immediate medical intervention or urgent health concerns were detected during the telemedicine interactions.

In the period of the study, 278 telemedicine consultations occurred, 113 patients were determined to have undergone more than 150 clinical events. These included uncontrolled seizures, worsening of co-morbidities, AED related issues, and more. Some of the communications were initiated by caregivers because AEDs were unavailable in the area, or the doses of the drugs were under question. Naturally, many caregivers were deeply concerned with COVID-19 symptoms or effects and also used telemedicine to discuss such issues.

Of all of the cases studied, 93% required increasing of the AED dosage, and 17% saw a new AED medication introduced. Only five of the children were required to seek immediate hospitalization for their condition.

Did it work? 96% of the caregivers asked about the medical advice received through telemedicine indicated satisfaction. This led the authors of the study to determine that telemedicine and teleconsultation were among the only “feasible options with good effectiveness for providing medical advice to children with epilepsy during pandemic times.”

Conclusion

Whether it is medicine or another area in which adaptations have been forced by the pandemic, many point to such innovations as the proverbial silver lining. In historically underserved or remote areas, the advancement of telemedicine as an option for effective and rapid diagnosis of issues relating to children's' epilepsy is a positive that has emerged out of difficult times.

 

 

Sources:

https://vsee.com/what-is-telemedicine/#:~:text=Telemedicine%20refers%20to%20the%20practice,HIPAA%20compliant%20video%2Dconferencing%20tools.

https://www.seizure-journal.com/article/S1059-1311(20)30209-0/fulltext

Topics: Pediatric Epilepsy