The features of clinical neurophysiology examination throughout the COVID-19 pandemic

Abstract

Tertiary care centers in Russia were subdivided on two categories during recent COVID-19 outbreak and counter infection measures, undertaken by the government. In the first category were the centers, providing medical care solely to the COVID-19 cases; in second hospitals worked with all other cases, excluding COVID-19 ones. COVID-19-oriented centers are taking strict protective measures against the infection, with medical and other staff working in the individual biohazard protection suits, full disinfection at the border between the clean and unclean zones, thorough medical supervision over the health of all the employees. In the second category centers observation regime was implemented, with the obligatory medical masks and disposable lab coats. wearing, as well as thorough medical supervision over the health of all the employees. These different regimes determine some features of clinical neurophysiology in these centers. In the case of electroencephalography (EEG) main point is the real need of the procedure in the certain clinical situation. In COVID-19 cases all functional tests should be excluded from the protocol; procedure have to be performed in shortest time possible. EEG is performed according to good clinical practice and consensus protocols with thorough and strict disinfection of the devise and all cables, caps etc. If the patient was in the prone position during the procedure, this should be noted for the neurophysiologist. Conduction studies may be performed in the possible coronavirus-associated Guillain–Barré syndrome or critical illness polyneuropathies. Needle myography may be needed only in the rare cases of coronavirus-associated acute myelitis, in all other cases conduction studies are more than enough.