Teleneurology in Veterinary Medicine for Neurolocalization

Abstract:

Background: Telemedicine is becoming increasingly utilized within veterinary medicine since the COVID-19 pandemic’s social distancing mandates. The validity and accuracy of telemedicine specifically for neurolocalization has yet to be investigated in the veterinary medicine. Hypothesis: Neuroanatomic lesion localization derived by teleneurology would have strong agreement with the in-person neurolocalization. Our secondary hypothesis was that review of video recorded neurological examinations would have less agreement compared to live-streamed neurological examinations. Animals: 55 client owned animals presenting to the neurology service.

Methods: Prospective cross-sectional study. Veterinary students on the neurology service performed a neurological examination. The examination was either recorded and viewed later by a neurologist, or performed and live streamed while viewed by a neurologist who was able to communicate with the student. All animals were then examined by either a neurologist or third year neurology resident blinded to the teleneurology results.

Results: A total of 30 dogs had recorded and 25 had live streamed neurological examinations. Both recorded (k=0.85, p<.0001) and live streamed (k=.84, p<.0001) neurological examinations had almost perfect correlation with the in-person neurolocalization. Four recorded and three live streamed cases had discordant results with the in person neurological examination. Conclusions and Clinical Relevance: The strong correlation for both recorded and live streamed neurological examinations show promise in neurolocalization with teleneurology. Further evaluation of accuracy with pet owners and primary care veterinarians is warranted.