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J Child Neurol ; 35(13): 924-933, 2020 11.
Article in English | MEDLINE | ID: covidwho-647100


OBJECTIVE: To evaluate the effect of the COVID-19 pandemic on global access to care and practice patterns for children with epilepsy. METHODS: We conducted a cross-sectional, online survey of pediatric neurologists across the world affiliated with the International Child Neurology Association, the Chinese Child Neurology Society, the Child Neurology Society, and the Pediatric Epilepsy Research Consortium. Results were analyzed in relation to regional burden of COVID-19 disease. RESULTS: From April 10 to 24, 2020, a sample of 212 respondents from 49 countries indicated that the COVID-19 pandemic has dramatically changed many aspects of pediatric epilepsy care, with 91.5% reporting changes to outpatient care, 90.6% with reduced access to electroencephalography (EEG), 37.4% with altered management of infantile spasms, 92.3% with restrictions in ketogenic diet initiation, 93.4% with closed or severely limited epilepsy monitoring units, and 91.3% with canceled or limited epilepsy surgery. Telehealth use had increased, with 24.7% seeing patients exclusively via telehealth. Changes in practice were related both to COVID-19 burden and location. CONCLUSIONS: In response to COVID-19, pediatric epilepsy programs have implemented crisis standards of care that include increased telemedicine, decreased EEG use, changes in treatments of infantile spasms, and cessation of epilepsy surgery. The long-term impact of these abrupt changes merit careful study.

Betacoronavirus , Coronavirus Infections/prevention & control , Delivery of Health Care/methods , Epilepsy/therapy , Health Care Surveys/methods , Internationality , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Telemedicine/methods , COVID-19 , Child , Cross-Sectional Studies , Electroencephalography/statistics & numerical data , Global Health , Health Care Surveys/statistics & numerical data , Humans , Neurologists , Neurology/methods , Pediatricians , Pediatrics/methods , SARS-CoV-2
J Child Neurol ; 35(12): 828-834, 2020 10.
Article in English | MEDLINE | ID: covidwho-611532


Circumstances of the COVID-19 pandemic have mandated a change to standard management of infantile spasms. On April 6, 2020, the Child Neurology Society issued an online statement of immediate recommendations to streamline diagnosis and treatment of infantile spasms with utilization of telemedicine, outpatient studies, and selection of first-line oral therapies as initial treatment. The rationale for the recommendations and specific guidance including follow-up assessment are provided in this manuscript. These recommendations are indicated as enduring if intended to outlast the pandemic, and limited if intended only for the pandemic health care crisis but may be applicable to future disruptions of health care delivery.

Coronavirus Infections , Pandemics , Pneumonia, Viral , Spasms, Infantile , Anticonvulsants/therapeutic use , Betacoronavirus , COVID-19 , Child , Coronavirus Infections/epidemiology , Electroencephalography , Humans , Infant , Pneumonia, Viral/epidemiology , Practice Guidelines as Topic , SARS-CoV-2 , Spasms, Infantile/diagnosis , Spasms, Infantile/therapy