Abstract Details

Title The Virtual Neurologic Exam: Instructional Videos and Guidance for the COVID-19 Era

Topic General Neurology

Presentation(s) General Neurology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 030

Objective 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.

Background The arrival of the COVID-19 pandemic necessitated a swift transition from in-
person to virtual care for most physicians. For neurologists, the ability to perform a detailed neurological examination is critical, and poses a barrier to virtual care adoption. Many aspects of the examination are not amenable to virtual platforms and require adapting standard techniques.

Design/Methods

We sought to develop a complete screening “virtual” neurological exam”
(VNE) that can be performed reliably in most circumstances, and also virtually and tailored depending on the nature of the referral. Videos were created to help with rapid adoption and demonstrate the techniques.

Results

Collaborating with general neurologists and various subspecialists (neuromuscular, cognitive neurology, movement disorders and neuro-ophthalmology), a complete VNE was developed, and is described in detail – complete with accompanying videos that demonstrate the most common maneuvers. We also provide guidance on the VNE for specific neurologic complaints, including cognitive impairment, neuromuscular disorders and movement disorders.

Conclusions

Given the importance of the physical exam to the practice of neurology, proficiency in performing a virtual neurological exam is an indispensable skill in the context of the COVID-19 pandemic and beyond. We have developed a practical approach to the VNE along with short instructional videos that can be easily implemented in clinical practice.

Authors/Disclosures
Mariam a. Al Hussona, MB BCh BAO PRESENTER	Dr. Al Hussona has nothing to disclose.
Monica E. Maher, MD	Dr. Maher has nothing to disclose.
David K. Chan, MD (St. Michael'S Hospital)	Dr. Chan has nothing to disclose.
	No disclosure on file
Jennifer Jain, MD, BSc (University of South Florida)	Dr. Jain has nothing to disclose.
Houman Khosravani, MD, PhD (Sunnybrook Health Sciences Centre, University of Toronto)	Dr. Khosravani has nothing to disclose.
Aaron E. Izenberg, MD (Sunnybrook Health Sciences Centre)	Dr. Izenberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Izenberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Izenberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genzyme. Dr. Izenberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexxion. Dr. Izenberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for alnylam.
Charles Kassardjian, MD, FAAN (St. Michael's Hospital - Clinical Neurophysiology)	Dr. Kassardjian has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi Genzyme. Dr. Kassardjian has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Kassardjian has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Argenx. Dr. Kassardjian has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. Dr. Kassardjian has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Astra Zeneca. Dr. Kassardjian has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Johnson and Johnson. Dr. Kassardjian has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Dr. Kassardjian has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Argenx. Dr. Kassardjian has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi Genzyme.
Sara B. Mitchell, MD (Dr. Sara Mitchell Medicine Professional Corporation)	Dr. Mitchell has nothing to disclose.

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