Chandrashekar Hoskote (United Kingdom)
National Hospital for Neurology and Neurosurgery Lysholm Department of NeuroradiologyAuthor Of 1 Presentation
THE QUEEN SQUARE BRAIN INFCETION AND ENCEPHALITIS MULTIDISCIPLINARY MEETING: PRE AND POST COVID-19 EXPERIENCE (2018 – 2021)
- Rachel Brown (United Kingdom)
Abstract
Background and Aims:
Patients with suspected encephalitis represent diagnostic challenges. Many potential aetiologies and presentations exist, crossing a wide range of disciplines, and often involving intensive care management. Outcomes can be devastating and are associated with ascertaining an early diagnosis and appropriate treatment. Acknowledging these challenges, in February 2018 we established a monthly encephalitis multidisciplinary team meeting (MDT). Input involved Neurology, Infectious Diseases, Microbiology, Virology, Immunology, Neuroradiology, Neuropathology, Neuropsychiatry and NeuroICU physicians. By necessity, the MDT expanded following the onset of the COVID-19 pandemic to a weekly virtual meeting accepting national referrals. We retrospectively reviewed our service to determine its impact over a 3-year period.
Methods:
MDTs are conducted in a standard format. Electronic referral proformas are pre-completed by referring teams, updated at the meeting and uploaded to patient records. We reviewed referral data, case records, and attendance registers, and gained feedback from referring/attending clinicians.
Results:
307 referrals (235 patients) were presented, with a rise in cases following the pandemic onset. Cases were broadly classified under neuroinflammatory, antibody-associated, neuro-infection, neuro-COVID, and mimics. Outcomes included diagnostic clarification, recommendations for specialised (often novel) diagnostics or treatment, and transfer of cases to specialist centres. Strong positive feedback from attendees confirmed the high clinical and educational benefit.
Conclusions:
Patients with suspected encephalitis need specialised multidisciplinary input, to ensure all possible differential diagnoses are considered. This facility is invaluable to physicians managing complex, unwell patients, including providing access and suggestions to novel diagnostics and therapies, and should be made available more widely. International cooperation by virtual technology should be encouraged.