Authors :
Presenting Author: Jagjot Singh, – Government Medical College, Amritsar, Punjab, India
Udeept Sindhu, MBBS – Rutgers New Jersey Medical School, Newark, NJ, USA
Abhishek Goyal, MBBS – HMH JFK University Medical Center, Edison, NJ, USA
Mary Schleicher, RN, BSN, MLIS, AHIP – Cleveland Clinic, Cleveland, OH, USA
Vineet Punia, MD – Cleveland Clinic, Cleveland, OH, USA
Rationale:
Epilepsy affects over 50 million people worldwide and requires frequent, specialized follow-up care. Yet access to neurologists and epileptologists is often limited by geographic distance, workforce shortages, and patient barriers (driving restrictions, seizure unpredictability). Telemedicine has emerged as a scalable solution to address these challenges¹, particularly since the COVID-19 pandemic². This systematic review aimed to evaluate the global use of telemedicine in epilepsy care and synthesize evidence comparing tele-epilepsy with in-person or usual care across seizure control, adherence, utilization, satisfaction, access, cost, and quality of life.
Methods:
Following PRISMA guidelines, we used an extensive search strategy developed in collaboration with a medical librarian to search MEDLINE, Embase, Scopus, and CENTRAL from inception to August 1, 2025 for articles on the use of telemedicine technologies to provide outpatient care to people with epilepsy. Two reviewers independently screened 3,283 titles and abstracts after removal of duplicates (initial sample was 6,574 articles). Disagreements were resolved by mutual agreement or the senior author. Forty articles met eligibility criteria after the review of 125 full text articles. Data was extracted using standardized forms for the synthesis of study characteristics and outcomes. The primary outcome was seizure control, with secondary outcomes including adherence, patient/provider satisfaction, access, and cost.
Results:
Forty studies from 13 countries enrolled 8,616 people with epilepsy (mean age 36 years, ~60% female). Most were single-center studies and evaluated either single modality (63%) or multimodal (37%) telemedicine interventions. The most commonly used telemedicine modalities were video conferencing via a web-based application, video conferencing + telephone calls, or secure messaging. Seizure outcomes were reported in 29 studies. Only 5 demonstrated improvement, and all of them used multimodal telemedicine services. Rest did not show any difference compared to in-person management or provided descriptive findings. By contrast, adherence, visit compliance, and patient satisfaction were consistently better with telemedicine, and several studies reported savings >$400 per patient (Table 2). Provider satisfaction was less frequently assessed but was generally favorable. Pandemic-era studies underscored the feasibility of telemedicine for maintaining continuity of care but did not consistently improve seizure outcomes. New 2024–2025 studies add post-pandemic real-world evidence supporting multimodal approaches.Conclusions:
Telemedicine is reliable for epilepsy follow-up care, adherence, satisfaction, and may lower costs while improving access. Its effect on seizure control remains unclear, though multimodal approaches appear more effective than single modality platforms. These findings support telemedicine as a reliable model for outpatient epilepsy care, while emphasizing that seizure control must remain a central outcome in future randomized trials directly comparing in-person care with multimodal vs. single modality care.
References:
1. Pharmacol Res. 2022 Dec;186:106550.
2. Med Res Arch. 2024;12(4).
Funding: None