Subject(s)
American Indian or Alaska Native , Black or African American , COVID-19/complications , COVID-19/ethnology , Hispanic or Latino , Nervous System Diseases/ethnology , Anosmia/epidemiology , Anosmia/ethnology , Anosmia/physiopathology , Autonomic Nervous System Diseases/epidemiology , Autonomic Nervous System Diseases/ethnology , Autonomic Nervous System Diseases/physiopathology , COVID-19/epidemiology , COVID-19/physiopathology , Cognitive Dysfunction/epidemiology , Cognitive Dysfunction/ethnology , Cognitive Dysfunction/physiopathology , Dysgeusia/epidemiology , Dysgeusia/ethnology , Dysgeusia/physiopathology , Headache/epidemiology , Headache/ethnology , Headache/physiopathology , Health Status Disparities , Humans , Memory Disorders/epidemiology , Memory Disorders/ethnology , Memory Disorders/physiopathology , Muscle Weakness/epidemiology , Muscle Weakness/ethnology , Muscle Weakness/physiopathology , Muscular Diseases/epidemiology , Muscular Diseases/ethnology , Muscular Diseases/physiopathology , Myalgia/epidemiology , Myalgia/ethnology , Myalgia/physiopathology , Nervous System Diseases/epidemiology , Nervous System Diseases/physiopathology , Peripheral Nervous System Diseases/epidemiology , Peripheral Nervous System Diseases/ethnology , Peripheral Nervous System Diseases/physiopathology , SARS-CoV-2 , Severity of Illness Index , Stroke/epidemiology , Stroke/ethnology , Stroke/physiopathology , United States/epidemiology , Post-Acute COVID-19 SyndromeABSTRACT
INTRODUCTION/AIMS: Telemedicine may be particularly well-suited for myasthenia gravis (MG) due to the disorder's need for specialized care, its hallmark fluctuating muscle weakness, and the potential for increased risk of virus exposure among patients with MG during the coronavirus disease 2019 (COVID-19) pandemic during in-person clinical visits. A disease-specific telemedicine physical examination to reflect myasthenic weakness does not currently exist. METHODS: This paper outlines step-by-step guidance on the fundamentals of a telemedicine assessment for MG. The Myasthenia Gravis Core Exam (MG-CE) is introduced as a MG-specific, telemedicine, physical examination, which contains eight components (ptosis, diplopia, facial strength, bulbar strength, dysarthria, single breath count, arm strength, and sit to stand) and takes approximately 10 minutes to complete. RESULTS: Pre-visit preparation, remote ascertainment of patient-reported outcome scales and visit documentation are also addressed. DISCUSSION: Additional knowledge gaps in telemedicine specific to MG care are identified for future investigation.