To outline features of the neurologic examination that can be performed virtually through telemedicine platforms (the virtual neurological examination VNE), and provide guidance for rapidly pivoting ...in-person clinical assessments to virtual visits during the COVID-19 pandemic and beyond.
The full neurologic examination is described with attention to components that can be performed virtually.
A screening VNE is outlined that can be performed on a wide variety of patients, along with detailed descriptions of virtual examination maneuvers for specific scenarios (cognitive testing, neuromuscular and movement disorder examinations).
During the COVID-19 pandemic, rapid adoption of virtual medicine will be critical to provide ongoing and timely neurological care. Familiarity and mastery of a VNE will be critical for neurologists, and this article outlines a practical approach to implementation.
Background and objectives:
Epileptic seizures frequently occur in people with multiple sclerosis (MS) and are thought to represent a manifestation of cortical pathology. However, at present, seizures ...are not considered to be a typical clinical presentation of demyelination.
Methods and results:
In this case series, we identified four people, who presented with seizures as a sole presenting feature, with demyelinating imaging abnormalities that satisfy current diagnostic criteria for a clinically isolated syndrome (CIS) or early MS.
Conclusion:
Based on this case series, we propose that people presenting with de novo seizures, with concurrent radiological abnormalities suggestive of demyelination could potentially be considered to have a CIS.
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