From the Department Neurology (J.A.F.), NYU Grossman School of Medicine New York University, NY; Epilepsy Unit (M.J.B.), International Bureau for Epilepsy, Scottish Epilepsy Initiative, Glasgow, Scotland; Neurology (R.C.), Hospital J P Garrahan, Buenos Aires, AR; Department Neurology (O.D.), NYU Grossman School of Medicine, NY; Institute of Neurology (D.D.), Huashan Hospital, Fudan University, Shanghai, China; Cleveland Clinic Epilepsy Center (L.J.), Cleveland, OH; Department of Neurology (N.J.), Icahn School of Medicine at Mount Sinai, New York, NY; Division of Epilepsy (A.K.), Department of Neurology, Miller School of Medicine, University of Miami, FL; Cincinnati Children's Hospital Medical Center (A.C.M.), School of Medicine, University of Cincinnati, OH; KEMRI-Wellcome Programme (C.R.N.), Kilifi, Kenya and Department of Psychiatry (C.R.N.), University of Oxford, United Kingdom; Division of Epilepsy and Clinical Neurophysiology (A.A.P.), Department of Neurology, Harvard Medical School, Boston Children's Hospital, MA; Harvard Medical School (P.B.P.), Brigham and Women's Hospital, Boston, MA; Department of Internal Medicine and Therapeutics (E.P.), University of Pavia and IRCCS Mondino Foundation, Member of the ERN EpiCARE, Pavia, Italy; UCL Queen Square Institute of Neurology (J.W.S.), London, United Kingdom and Stichting Epilepsie Instelligen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands; University of Melbourne (I.E.S.), Austin and Royal Children's Hospitals, Florey and Murdoch Children's Research Institutes, Melbourne, Australia; Dayanand Medical College (G.S.), Ludhiana, India; Matthew's Friends-Ketogenic Dietary Therapies (E.W.), London, United Kingdom; Department of Paediatric Neurology (J.W.), Red Cross War Memorial Children's Hospital, Neuroscience Institute, Cape Town, South Africa; and UCL NIHR BRC Great Ormond Street Institute of Child Health (J.H.C.), Great Ormond Street Hospital for Children, London, United Kingdom and Member of the ERN EpiCARE (J.H.C.), Young Epilepsy, Lingfield, United Kingdom.
Neurology. 2020 Jun 9;94(23):1032-1037. doi: 10.1212/WNL.0000000000009632. Epub 2020 Apr 23.
To provide information on the effect of the coronavirus disease of 2019 (COVID-19) pandemic on people with epilepsy and provide consensus recommendations on how to provide the best possible care for people with epilepsy while avoiding visits to urgent care facilities and hospitalizations during the novel coronavirus pandemic.
The authors developed consensus statements in 2 sections. The first was "How should we/clinicians modify our clinical care pathway for people with epilepsy during the COVID-19 pandemic?" The second was "What general advice should we give to people with epilepsy during this crisis? The authors individually scored statements on a scale of -10 (strongly disagree) to +10 (strongly agree). Five of 11 recommendations for physicians and 3/5 recommendations for individuals/families were rated by all the authors as 7 or above (strongly agree) on the first round of rating. Subsequently, a teleconference was held where statements for which there was a lack of strong consensus were revised.
After revision, all consensus recommendations received a score of 7 or above. The recommendations focus on administration of as much care as possible at home to keep people with epilepsy out of health care facilities, where they are likely to encounter COVID-19 (including strategies for rescue therapy), as well as minimization of risk of seizure exacerbation through adherence, and through ensuring a regular supply of medication. We also provide helpful links to additional helpful information for people with epilepsy and health providers.
These recommendations may help health care professionals provide optimal care to people with epilepsy during the coronavirus pandemic.
提供有关 2019 年冠状病毒病(COVID-19)大流行对癫痫患者的影响的信息,并就如何在新型冠状病毒大流行期间为癫痫患者提供尽可能好的护理提供共识建议,同时避免前往急救护理设施和住院。
作者在两个部分制定了共识声明。第一部分是“在 COVID-19 大流行期间,我们应该如何/临床医生应该如何修改我们为癫痫患者提供的临床护理路径?”第二部分是“在这场危机期间,我们应该向癫痫患者提供哪些一般建议?”作者个人对每个声明进行了-10(强烈不同意)到+10(强烈同意)的评分。对医生的 11 条建议中的 5 条和对个人/家庭的 3/5 条建议,在第一轮评分中,所有作者均将其评为 7 分或以上(强烈同意)。随后,举行了电话会议,对缺乏强烈共识的声明进行了修订。
修订后,所有共识建议的评分均达到 7 分或以上。这些建议侧重于尽可能在家庭中提供护理,使癫痫患者远离可能接触到 COVID-19 的医疗机构(包括抢救治疗策略),以及通过坚持治疗和确保药物的定期供应来尽量减少癫痫发作加重的风险。我们还为癫痫患者和医疗服务提供者提供了额外有用信息的链接。
这些建议可能有助于医疗保健专业人员在冠状病毒大流行期间为癫痫患者提供最佳护理。