Abstract Details

Title Distinguishing Peripheral from Central Nervous System Disease by Telemedicine

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P04 - (-)

Poster/Presentation
Number 059

Objective

Background BACKGROUND: The utility of telemedicine for providing emergency care for patients with stroke (telestroke) has been established. The role of telemedicine in the evaluation of patients with other neurological disorders, has not been well-studied.

Design/Methods DESIGN/METHODS: A review of all patients who underwent emergency neurological audio-video telemedicine consultation at our institution's regional hub and spoke network over the prior two years was performed. Patients who received a clinical diagnosis of a PNS disorder were identified. Clinical and radiographic findings at the time of the initial telemedicine consultation were recorded, and when possible, follow-up clinical, electrodiagnostic, and radiographic findings were collected and compared.

Results RESULTS: A total of 14 patients were diagnosed with a disorder of the PNS at the time of telemedicine consultation. All of these patients were considered by referring spoke providers to have had a possible stroke. Patients ranged in age from 20-72 years old (mean 48), and 9 of the 14 were male. PNS diagnoses included Bell's palsy in 8, Guillain-Barre syndrome (GBS) in 3, ulnar neuropathy in 1, and an undifferentiated PNS process in 2 patients. Follow-up information was available in 12 patients. A CNS disorder was not identified in any of these patients. Follow-up studies confirmed the initial telemedicine diagnosis in all 6 of the patients diagnosed with Bell's palsy (follow-up information available), 2 of the 3 patients diagnosed with GBS, and in the 1 patient diagnosed with ulnar neuropathy.

Conclusions CONCLUSIONS: This preliminary study suggests that: 1) telemedicine neurology consultation can reliably differentiate PNS from CNS disorders; 2) accurate PNS diagnoses can be established through telemedicine consultation in the majority of patients; and 3) expansion of telemedicine for non-cerebrovascular neurological disorders should be pursued.

Authors/Disclosures
Brent P. Goodman, MD (Dept of Neuro /Mayo Clinic) PRESENTER	Dr. Goodman has nothing to disclose.
Kevin M. Barrett, MD, FAAN (Mayo Clinic)	Dr. Barrett has nothing to disclose.
Douglas L. Arnold, MD, FAAN (Montreal Neurological Institute, McGill Univ)	Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for BMS. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Frequency Therapeutics. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merck. Dr. Arnold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Arnold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shionogi. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Xfacto communications. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Find therapeutics. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GSK. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Idorsia. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kiniksa. Dr. Arnold has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Clario.
Dwight Channer, MS (Mayo Clinic Hospital)	No disclosure on file
Bart Demaerschalk, MD, MSc, FRCPC, FAAN (Mayo Clinic)	Dr. Demaerschalk has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Demaerschalk has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shionogi. Dr. Demaerschalk has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for The Neurologist . The institution of Dr. Demaerschalk has received research support from NICHD.

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