Keeping people with epilepsy safe during the COVID-19 pandemic.

Charles R Newton, J Helen Cross, Jo Wilmshurst, Emma Williams, Gagandeep Singh, Ingrid E Scheffer, Josemir W Sander, Emilio Perucca, Page B Pennell, Archana A Patel, Jacqueline A French, Avani C Modi, Andres Kanner, Nathalie Jette, Lara Jehi, Ding Ding, Orrin Devinsky, Roberto Caraballo, Martin J Brodie

Journal: Neurology 2020;94(23):1032-1037

PMID: 32327490

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Abstract

OBJECTIVES

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.

METHODS

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.

RESULTS

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.

CONCLUSION

These recommendations may help health care professionals provide optimal care to people with epilepsy during the coronavirus pandemic.

Address: 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. [email protected].; 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.

DOI: 10.1212/WNL.0000000000009632

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MeSH Terms: Betacoronavirus, COVID-19, Coronavirus Infections, Epilepsy, Humans, Pandemics, Pneumonia, Viral, SARS-CoV-2