Table 3.

Follow-up: assessing disability and relapses in MS on teleneurology

3.1 Neurological examination can be partially performed using video call. Limitations are recognized for the evaluation of sensory, sensitivity, cranial nerve evaluation, vestibular examination, reflexes, and tone, among others

3.2 The neurological examination via video call does not replace the face-to-face physical examination, although it can provide the neurologist with certain information about the patient’s physical characteristics

3.3 The use of “tele-EDSS” thought telemedicine is useful during patient follow-up to determine the impact of MS 3.4 The use of webcam-based EDSS is recommended in those MS patients with EDSS > 6.0 who live at considerable distances from specialized centers, since it provides clinically valid information 3.5 The use of a webcam-based EDSS as the only via of evaluation is not recommended in those MS patients with EDSS < 6.0 as subtle neurological deficits cannot be identified 3.6 The use of the patient-determined disease steps (PDDS) thought telemedicine is useful during patient follow-up to determine the impact of MS 3.7 The timed 25-foot walk (T25FW) can be evaluated at home if MS patients or their caregiver are instructed previously 3.8 Beck Depression Inventory II (BDI-II) can be used through teleconsultation as a specific tool to report depressive symptoms 3.9. Fatigue severity scale (FSS) can be used through teleconsultation as a screening tool for fatigue 3.10 The use of the multiple sclerosis international quality of life questionnaire (MusiQoL) is recommended as a specific quality of life measurement through teleconsultation 3.11 The subjective report of cognitive alterations can be evaluated by means of telemedicine, using a self-report questionnaire with validations in the local population 3.12 A full neuropsychological assessment can be applied through video call, using tests with validations in the local population and when face-to-face consultation has not been possible 3.13 A self-administered neuropsychological assessment can be conducted by means of telemedicine using tests with validations in the local population and when the face-to-face consultation has not been possible 3.14 The remote version of symbol digit modalities test (SDMT) can be useful as a screening tool for cognitive assessment or as a complement to comprehensive evaluations 3.15 A comprehensive neuropsychological face-to-face assessment for anyone who tests positive in remote SDMT screening test should be performed 3.16 The administration of the remote version of SDMT should be guided by a trained professional 3.17 Virtual neurological and cognitive monitoring measures should be validated in Argentina