Jang Yoonhyuk, Moon Jangsup, Lee Soon-Tae, Lee Sang Kun, Chu Kon
Department of Neurology, Laboratory for Neurotherapeutics, Comprehensive Epilepsy Center, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Department of Genomic Medicine, Seoul National University Hospital, Seoul, Korea.
Encephalitis. 2022 Jul;2(3):65-72. doi: 10.47936/encephalitis.2022.00024. Epub 2022 Jun 20.
Telemedicine is an emerging field of medicine that has become more important during the coronavirus disease 2019 (COVID-19) pandemic era and is being studied actively in various medical fields. In neurology, the introduction of telemedicine is accelerating worldwide under the label of teleneurology. So far, few studies have been conducted on telemedicine for patients with epilepsy. In nonmetropolitan areas, video-based clinics have been demonstrated to be effective for seizure control, and smartphone-based diagnosis has also been confirmed to be accurate. Indeed, after the onset of the COVID-19 pandemic, telemedicine has been used to treat patients with epilepsy around the world. Few studies have examined the use of telemedicine for patients with autoimmune encephalitis. One showed that telephone-based evaluation is sufficient to assess the cognitive reserve of leucine-rich glioma inactivated-1-antibody encephalitis patients, thereby diagnosing their dementia. Telephone-based outpatient clinics are temporarily permitted under Korean medical law, and telemedicine can be attempted for clinically stable patients with epilepsy in Korea. In addition, patients with autoimmune encephalitis in stable or improving status may also be candidates for treatment with telemedicine. This review presents evidence for the safety and efficacy of telemedicine to treat epilepsy and encephalitis patients and discusses indication guidelines. Based on our literature review and current Korean medical law, we suggest tentative guidelines for telemedicine in the fields of epilepsy and autoimmune encephalitis.
远程医疗是医学领域的一个新兴领域，在2019冠状病毒病（COVID-19）大流行期间变得更加重要，目前正在各个医学领域积极开展研究。在神经病学领域，远程医疗的引入正在以远程神经病学的名义在全球范围内加速推进。到目前为止，针对癫痫患者的远程医疗研究较少。在非大都市地区，基于视频的诊所已被证明对癫痫发作控制有效，基于智能手机的诊断也已被证实准确无误。事实上，自COVID-19大流行开始以来，远程医疗已被用于治疗世界各地的癫痫患者。针对自身免疫性脑炎患者使用远程医疗的研究很少。一项研究表明，基于电话的评估足以评估富含亮氨酸的胶质瘤失活-1抗体脑炎患者的认知储备，从而诊断其痴呆症。根据韩国医学法律，暂时允许开设基于电话的门诊诊所，在韩国，对于临床稳定的癫痫患者可以尝试使用远程医疗。此外，病情稳定或正在改善的自身免疫性脑炎患者也可能是远程医疗治疗的候选对象。本综述提供了远程医疗治疗癫痫和脑炎患者的安全性和有效性的证据，并讨论了适应症指南。基于我们的文献综述和韩国现行医学法律，我们提出了癫痫和自身免疫性脑炎领域远程医疗的暂行指南。
