Neurological examination is possible using telemedicine.
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Date
2000-01-21
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Abstract
To compare the reliability of neurological examination performed by telemedicine and face to face a junior doctor examined 23 patients face to face these examinations being witnessed either by one or by two telemedicine observers using a telemedicine video link at 384 kbit s The gold standard was a face to face examination from a panel of six consultant neurologists Power deep tendon reflexes plantar responses coordination sensation eye movements facial strength tongue movements sitting balance and gait were studied Seventeen patients satisfied the inclusion criteria and a total of 1 084 matched pairs of observations were made The reliability of the telemedicine examination ranged from fair to moderate for deep tendon reflexes coordination and eye movement to near perfect for plantar responses Overall examination by telemedicine compared favourably with face to face examination Telemedicine examination was more sensitive in detecting abnormalities than face to face examination for all the neurological tests studied and more specific for all but one plantar responses The study showed that neurological examination using telemedicine is at least as good as face to face examination performed by a junior doctor