To analyze the accuracy of video and telephone consultations in the setting of an outpatient neurology clinic when compared to in person office assessments. 

1036 out of 1484 patients were included in this study who had both virtual and in person assessments. 27.8% (n=288) of consultations were video and 72.2% (n=748) telephone. A total of 13.8% (n=143) of virtual consultations revealed DISP, specifically 13.5% (n=39) video and 13.9% (n=104) telephone consultations. Of all the 1036 cases, 2.32% (n=24) patients stated they were stable but significant changes were seen on exam, changing the clinical impression. 11.5% (n=119) of patients stated they were deteriorating virtually but was not confirmed with in person assessment, with alternative explanation.

Virtual assessments were accurate in over 85% of the outpatient neurological cases during the pandemic. However, the in person neurological exam led to a change in clinical opinion in 13.8% of assessments. 2.32% patients described clinical stability, but clinical management was altered when significant exam findings were identified, including subtle weaknesses, abnormal reflexes, sensory changes, not identified virtually.