TELEMEDICINE IN NEUROLOGY SINCE THE COVID-19 PANDEMIC

ABSTRACT

The Covid-19 pandemic has boosted telemedicine (TLM) for acute and chronic neurological disorders and it has demonstrated its cost/efficiency benefits. Before the Covid-19 pandemic, TLM was used mainly for the acute stroke management to deliver thrombolysis and select mechanical thrombectomy in rural and underserved areas. To the opposite, experiences for chronic neurological disorders were limited before the Covid-19 pandemic. Covid-19 pandemic suggests to re-think neurological practices. Therefore, it was observed that neurological diseases are compatible with tele-consultation, teleassistance and tele-expertise, because clinical symptoms are accessible to simple questionnaires, functional scales and expert visual observation. The new use of TLM has demonstrated its efficiency for stroke but also for chronic neurological diseases as Multiple Sclerosis, Epilepsy, Parkinson and Alzheimer diseases, Atrophic Lateral Sclerosis, Myasthenia gravis, neuromuscular diseases, post-traumatic lesions and psychiatric disorders. Moreover, TLM is safe, it allows treatments changes, it protects patient confidentially, it safeguards the privacy of participants. TLM improves quality of life, allowing to the patients to hold the tele-visit in familiar environment in a multidisciplinary approach, with a strong correlation compared with the equivalent face-to-face visit. This new medical practice provides multiple consequences TLM training is necessary, and governments, health care systems and payers should be encouraged to continue to develop its generalization. Conclusion: TLM for acute and chronic neurological disorders presents 4 advantages better access to care, greater convenience, enhanced patient comfort, better confidentiality. TLM must become a new normality rather than exception, while standard operating procedures and legal framework are essential.