随着远程医疗服务在COVID-19大流行期间救助慢性神经系统疾病患者,对于儿童神经系统疾病,需要简化的远程神经病学方案。婴儿痉挛是一种癫痫性脑病,治疗滞后是预后的重要预测因素。在这种情况下,远程医疗可以在延迟或无法进行面对面咨询时产生显着差异。然而,一线治疗方案的不良反应,需要频繁的随访,不发达的远程医疗服务,缺乏合理的协议,对婴儿痉挛的认识很差,父母的理解水平较低,儿童神经学家的匮乏是发展中国家的主要障碍。本文提供了一种基于远程神经学的方法,用于在COVID-19大流行期间管理发展中国家的婴儿痉挛。这种方法的基石包括管理婴儿痉挛的基本原则,将病人护理下放给当地卫生提供者,努力提高诊断的敏感性和特异性,早期开始一线治疗选择,以及父母和当地卫生提供者对治疗反应保持警惕的持续动力,治疗的不良反应,和感染。
With telehealth services rescuing patients with chronic neurological disorders during the COVID-19 pandemic, there is a need for simplified teleneurology protocols for neurological disorders in children. Infantile spasms is an epileptic encephalopathy where treatment lag is a significant predictor of outcome. It is one such condition where telemedicine can make a remarkable difference when in-person consultations are delayed or are not possible. However, the adverse effect profile of the first-line therapeutic options, the need for frequent follow-up, underdeveloped telemedicine services, lack of a rational protocol, poor awareness about infantile spasms, a lesser level of parental understanding, and scarcity of pediatric neurologists are the major hurdles in developing countries. This paper provides a teleneurology based approach for the management of infantile spasms in developing countries during the COVID-19 pandemic. The cornerstones of this approach include the fundamental principles of management of infantile spasms, decentralization of patient care to local health providers, efforts for improving sensitivity and specificity of diagnosis, early initiation of first-line therapeutic options, and constant motivation of parents and local health providers to be vigilant for therapeutic response, adverse effects of therapy, and infections.