According to a review of the evidence conducted by the American Academy of Neurology (AAN) and published in the journal Neurology, seeing a neurologist by video may be as effective as an in-person visit. The results from the review indicate that a diagnosis from a neurologist by video for certain neurologic conditions is likely to be as accurate as an in-person visit.
Studies found that individuals and their caregivers were just as satisfied with virtual doctor visits as they were with in-person visits. Some studies show that using telemedicine is as effective as in-person visits to make accurate diagnoses and in some cases may show improved health outcomes. However, few randomized, controlled studies have been conducted on telemedicine for neurology, outside of stroke. In many areas, little research has been done.
For the evidence review, 101 studies were analyzed on telemedicine use in the areas of concussion and traumatic brain injury, dementia, epilepsy, headache, multiple sclerosis, movement disorders, neuromuscular conditions, and general neurology. The authors note that evidence for the use of telemedicine for stroke is an exception in that it is well-established and evidence-based.
"Telemedicine can be especially helpful for people with epilepsy, who may not be able to drive to appointments, people with neurologic disorders like multiple sclerosis and movement disorders, who may have mobility issues that make getting to a clinic difficult, and, of course, for people in rural areas who may not be able to see a neurologist based hours away without making that trip," said lead author Jaime Hatcher-Martin, MD, PhD, who was with Emory University in Atlanta while serving on the American Academy of Neurology's Telemedicine Work Group, is now with the company SOC Telemed and is a member of the American Academy of Neurology. "Another effective use may be for evaluating people with possible concussions, where telemedicine could be used on-site to make an immediate diagnosis. For sports injuries, it could be used to make a decision on whether the athlete is ready to return to the field."
"We need to conduct further studies to better understand when virtual appointments are a good option for a patient. Keep in mind that telemedicine may not eliminate the need for people to meet with a neurologist in person. Rather, it is another tool that can help increase people's access to care and also help lessen the burden of travel and costs for patients, providers, and caregivers." said senior author Raghav Govindarajan, MD, of the University of Missouri, who served as a chair on the American Academy of Neurology's Telemedicine Work Group and is a fellow of the American Academy of Neurology.
Neha M. Kramer, MD; Jessica Besbris, MD; and Rima M. Dafer, MD, MPH
Monika Krzesniak-Swinarska, MD
Farhat Husain, MD; Divya Singhal, MD; and Sergio Ramirez Salazar, MD