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Experiences from an International Tele-Epilepsy Collaboration

Published online by Cambridge University Press:  02 December 2014

S. Nizam Ahmed ,
Carly Mann ,
Fowzia Siddiqui ,
Mughis Sheerani ,
Nadir Ali Syed ,
Thomas Snyder ,
S. Ather Enam  and
Warren Boling
S. Nizam Ahmed*
Affiliation:
University of Alberta, Edmonton, Alberta, Canada
Carly Mann
Affiliation:
Alberta Health Services, Edmonton, Alberta, Canada
Fowzia Siddiqui
Affiliation:
Aga Khan University, Pakistan
Mughis Sheerani
Affiliation:
Aga Khan University, Pakistan
Nadir Ali Syed
Affiliation:
Aga Khan University, Pakistan
Thomas Snyder
Affiliation:
University of Alberta, Edmonton, Alberta, Canada
S. Ather Enam
Affiliation:
Aga Khan University, Pakistan
Warren Boling
Affiliation:
University of West Virginia, West Virginia, USA
*
University of Alberta, 8440 -112 Street, WCM, Health Sciences Centre, Edmonton, Alberta, T6G 2B7, Canada
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Abstract

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Objective:

Our main objective was to use videoconferencing as a primary means to: a) assist in launching an epilepsy surgery program in Pakistan; 2) participate in case conferences on complex epilepsy patients in each country.

Methods:

Extensive testing using both point to point and bridged integrated service digital network (ISDN) and internet protocol (IP) connections was carried out using bandwidths of 384-768 kilobits per second (kbps). Videoconferences between sites were arranged two to three weeks in advance and connections were tested a day prior to the scheduled conference. Sharing of PowerPoint presentations, neuroimaging and video-EEG was available to all sites. Discussions centered on patients with medically refractory epilepsy.

Results:

Between July 2006 and June 2008, 17 sessions were booked. Five of these conferences bridged in specialists from West Virginia University. Most successful connections occurred using IP point to point calls or a bridge connecting end points through IP at 512 kbps. We conducted three surgeries for medically refractory temporal lobe epilepsy in Pakistan. At follow-up in January 2009, two patients have been seizure free and one had two breakthrough seizures after sudden unsupervised discontinuation of Levetiracetam.

Conclusion:

Our international tele-epilepsy collaboration has proven feasible and valuable to all participants. Our experience suggests considerable thought and preparation are needed before a teleconference to ensure its success. We provide a recipe to set-up similar telemedicine collaborations. Considerations include time zone differences, equipment type, interoperability between endpoints, connection capabilities, bandwidth availability, and backup plans for unsuccessful connections. Telemedicine can facilitate epilepsy care around the world, identifying with the concept of a “Global Health Village”.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 36 , Issue 5 , September 2009 , pp. 582 - 586
Copyright
Copyright © The Canadian Journal of Neurological 2009

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