Care Delivery for Children With Epilepsy During the COVID-19 Pandemic: An International Survey of Clinicians. (November 2020)

• Record Type: Journal Article
• Authors: Wirrell, Elaine C.; Grinspan, Zachary M.; Knupp, Kelly G.; Jiang, Yuwu; Hammeed, Biju; Mytinger, John R.; Patel, Anup D.; Nabbout, Rima; Specchio, Nicola; Cross, J. Helen; Shellhaas, Renée A.
• Is Part Of: Journal of child neurology. Volume 35:Number 13(2020:Dec.)
• Page Start: 924
• Page End: 933
• Publication Date: 2020-11
• Subjects: epilepsy -- epilepsy surgery -- infantile spasms -- telemedicine; Nervous system -- Diseases -- Periodicals; 618.928
• DOI: 10.1177/0883073820940189
• Languages: English
• ISSNs: 0883-0738

Abstract

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.