Thursday, March 19, 2020

Pediatric Neurology Services at Home During Corona / Covid -19

Image result for covid 19 child
Social Distancing Saves Lives in Child Neurology Too
19 March 2020

Subject: Dr. Rotenberg, Kara Schmidt, Testing and EEG  - Appointments during Coronavirus Emergency 
  • The State of Texas is in the midst of a public health emergency due to coronavirus. 
  • It is imperative to “flatten the curve” of this pandemic by practicing strict social distancing. 
  • Our practice is committed to our patients' needs. 
  • We need to make changes to safely deliver care under these unusual circumstances. 
  • Telemedicine visits are an established part of our practice.  It's business as usual. 
Therefore, effective immediately: 
  1. All appointments will be moved to telemedicine status ONLY. 
  2. New patients will be completed by telemedicine ONLY
  3. Most testing, dietician consults will be completed by telemedicine.  
  4. There will be very few exceptions based on medical need. 
  5. EEG visits will be rescheduled to a different time or place. 
Regarding pulmonary:  Dr. Susarla to release updated guidelines later today. 

This process will stay in place during the course of this emergency. 

Please call your insurance and/or employer to check telemedicine benefits. 

Thank you, 

Dr. Rotenberg 

Information on Covid19

Texas Telemedicine

Governor Abbott Waives Certain Regulations For Telemedicine Care In Texas

March 17, 2020 | Austin, Texas | Press Release
Governor Greg Abbott today waived certain regulations and directed that the Texas Department of Insurance (TDI) issue an emergency rule, all relating to telemedicine care for patients with state-regulated insurance plans to help doctors across Texas continue to treat their patients while mitigating the spread of COVID-19. The suspensions and emergency rule will work together to allow telemedicine visits for patients with state-regulated plans to be paid the same as in-office visits for insurance purposes. These actions build upon waivers the Governor issued last week of portions in the Occupations Code to expand provider flexibility in providing medical services over the phone.
“As the State of Texas responds to COVID-19, we continue to work to maintain regular health care services and operations throughout the state, and telemedicine is one of the most valuable tools we have to ensure Texans continue to receive the health services they need,” said Governor Abbott. “Expanding telemedicine options will help protect the health of patients and health care professionals, and help Texas mitigate the spread of COVID-19.”
Doctors will be eligible for payment from insurance plans regulated by TDI for medical visits they conduct over the phone instead of in-person at the same rate they would receive for in-person visits. 
Medical providers seeking guidance on the impact of the new rule can expect guidance from the Texas Medical Board to be issued in the coming days, including administrative guidance for billing to ensure that claims are processed smoothly.
Insurers seeking guidance on implementation of the emergency rule should contact TDI or visit their webpage for more information.
This coordinated efforts between the Office of the Governor, the Texas Department of Insurance, the Texas Medical Board, and health insurance plans will increase access to health care for all Texans. Today’s action will expand telemedicine options by giving health care providers greater flexibility to perform audio-only telephone consultations with their patients.
As a reminder, Texans covered by CHIP or Medicaid will not be charged copays for test or telemedicine consults. Individuals covered by Medicare or large employer plans should check with their health plan administrator to determine their specific benefits. 

Wednesday, March 18, 2020

Epilepsy & Covid-19 Coronavirus

Epilepsy Coronavirus Covid-19 -  A great site from the Epilepsy Foundation

FB meetup on 18 March

Concerns About COVID-19 (Coronavirus) and Epilepsy

  • Are people with epilepsy at higher risk of developing COVID-19 (coronavirus)?
  • Can COVID-19 increase seizures if a person gets the virus?
  • How can I get more medicine if my health care provider prescribes it?
  • Are there shortages in seizure medicines in the United States?
  • If COVID-19 is in my community, what should I do?
  • How do I protect myself from getting sick?
  • We are Here for You!

Wednesday, March 04, 2020

Magnesium, tics, Tourette syndrome

Magnesium Tourette Syndrome and Tics

I often have questions about magnesium for tics and Tourette’s syndrome.

 One open label study showed benefit using IV magnesium with B6. It appears that a double blind placebo controlled trial was planned but results have not been published.

One must keep in mind that the potential side-effects of high doses of magnesium are probably unsafe and that magnesium itself can have side effects.

So, is the Research promising? Yes.
Do I recommend IV magnesium for tics? Normally, no. There are too many risks.
Screen for magnesium or zinc deficiency in at-risk children? I think so.

Articles on pubmed are here often have questions about magnesium for ticks and Tourette’s syndrome.