key: cord-0853808-6yo5e26z authors: Nakamoto, Max; Carrazana, Enrique; Viereck, Jason; Liow, Kore title: Epilepsy in the time of COVID‐19 date: 2020-11-06 journal: Acta Neurol Scand DOI: 10.1111/ane.13360 sha: f5514b11e4ba20b9b6f10693c0f18f9daecb41be doc_id: 853808 cord_uid: 6yo5e26z We read with interest the recent paper by Fonseca et al. (1) in which they reported the effects of the COVID-19 pandemic on their Epilepsy clinic's patients in Spain who were assessed through a telephonic survey during the first month of confinement (16 March 2020 - 17 April 2020). Their work provides important insight into the impact of the pandemic on persons with Epilepsy, particularly in major outbreak areas. the impact of the pandemic on persons with epilepsy, particularly in major outbreak areas. Similar to Spain, the United States (US) has been significantly impacted by the COVID-19 pandemic. 2 However, the severity of disease burden has varied considerably among the various States. As of 5 September 2020, Hawaii accounted for only 9473 cases of the total 6 233 000 cases in the United States. 2, 3 Early government action in Hawaii has been credited with the state's low caseload. These measures included early mandatory confinement (April-May 2020); closure of non-essential businesses, recreational parks, and beaches; requiring the wearing of facial masks; enforcing social distancing rules; and a mandatory 14-day quarantine for all incoming travelers to the islands. 3 Comparatively little is known about the impact of the pandemic on persons with epilepsy in areas of low disease prevalence, like Hawaii. Hawaii Pacific Neuroscience conducted a telephonic survey on patients seen during the period of mandatory confinement (22 April 2020 to 18 May 2020). To be included in the study, patients must have had an appointment with the clinic, whether in-person or through telemedicine, during the time of mandatory confinement; all other patients were not considered for inclusion. Patient information and survey responses were de-identified. The study was conducted as a clinic-oriented, quality-improvement survey and was therefore deemed exempt from the Institutional Review Board. At the beginning of each telephone interview, patients' verbal consent to participate was obtained, and they were informed that they could terminate their participation at any time during the interview. The survey was a structured questionnaire addressing four areas: general issues regarding their care, experience with telemedicine, general health and well-being, and disease-specific changes. Demographic information was also recorded for each participant. Out of 928 patients seen during these 4 weeks, telephone contact was established with 429 (46%) patients, of which 367 (86%) agreed to participate. There was a wide representation of neurological diagnoses and demographic characteristics. Epilepsy was the primary diagnosis of 67 participants and was the condition for which these patients were seen at their appointment during the period of mandatory confinement. Diagnosis of epilepsy was made in accordance with the 2014 ILAE definition of epilepsy. 4 a Analyses were run only on responses from participants that had a telemedicine appointment during the pandemic. b Analyses were run only on responses from participants that were employed prior to the pandemic (n = 47 for epilepsy, n = 199 for non-epilepsy). The authors have no conflicts to declare relevant to this work. After publication, anonymized data supporting the findings of this study are available from the authors upon reasonable request from any qualified investigator. Epilepsy in time of COVID-19. A survey-based study Medicine JHUo. COVID-19 Dashboard by the Center for Systems Science and Engineering Disease Outbreak Control Division -COVID-19 ILAE official report: a practical clinical definition of epilepsy Epilepsy in the time of COVID-19