JLE

Epileptic Disorders

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The future is now: pediatric neuropsychological presurgical epilepsy evaluation in the age of COVID-19 Volume 23, issue 2, April 2021

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Authors
1 Department of Neurology, University of Texas Health Austin Pediatric Neurosciences at Dell Children's, Austin, Texas, USA
2 Department of Pediatrics, Neurology Section, University of Colorado School of Medicine, Denver, Colorado, USA
3 Department of Educational Psychology, University of Texas at Austin, Austin, Texas, USA
* Correspondence: Nancy L. Nussbaum Department of Neurology, University of Texas Health Austin Pediatric Neurosciences at Dell Children's, 1600 W. 38th St., Suite 320, Austin, TX 78759, USA

Objective

The objective of this brief report is to review an assessment paradigm for conducting virtual neuropsychological pre-surgical evaluations in the context of the COVID-19 pandemic.

Methods

A multidisciplinary epilepsy team at a Level 4 epilepsy center within a large children's academic medical center convened to discuss the challenges and possible solutions for Phase II evaluations for pediatric patients with pharmacoresistant epilepsy during the COVID-19 pandemic. The neuropsychologists explored evidence-based methods of virtual evaluation and developed a systematic decision-making process for youth requiring a Phase II evaluation.

Results

We propose models of assessment which prioritize teleneuropsychology when possible to reduce the risk of infection: (1) evaluation with directly administered tests through a completely virtual format; (2) virtual/in-person hybrid evaluation; and (3) clinical observation/interview in a virtual format supplemented by survey data. These models are illustrated by three cases.

Significance

Using virtual assessment models, the team was able to meet the urgent patient care needs and collect useful data while minimizing the risk of virus spread. The paradigms presented may be useful examples for other multidisciplinary surgical teams interested in incorporating teleneuropsychology into their practices.