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The term “telestroke” was first introduced by Levine ad Gorman in 1999. Since then many telestroke networks have been developed throughout the world more than 22 in Germany alone, performing more than 38.211 teleconsultations per year. Most telestroke networks are organized in a hub and spokes system: one or several comprehensive stroke centers (hub), advise several regional or community hospitals (spoke) in stroke care. The degree of treatment possibilities in the spokes hospitals is highly variable; while some telestroke networks offer only hyperacute stroke treatment i.e. identifying strokes and performing thrombolysis onsite (TSRH-telemedicine-assisted Stroke Ready Hospitals), others have developed local stroke Units (TSU-Telemedical Stroke Units) and provide stroke care until the patient is discharged home/to a rehabilitation center. The backbone of every functioning telestroke network remains the implementation of standard operational procedures, regular staff trainings and quality management.

Nowadays, telestroke is going far beyond thrombolysis and stroke unit treatment - the ultimate goal being to treat stroke patients from the beginning to the end remotely as close to the patients home as possible. Multiple telestroke projects target stroke from the onset to its rehabilitation and follow up care. To mention only a few, mobile stroke Units including CT scanners have brought thrombolysis to the patients front door, interventionalists are been flown by helicopter to regional hospitals to perform thrombectomy onsite, and patients are being discharged home with telerehabilitation programs.

In conclusion, telestroke is a growing field, bringing qualitative and innovative stroke care closer to the patient.

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The risk of seizure occurrence is not uniform over time. Rather it fluctuates due to unknown factors at multiple time-scales including circadian, multidien (over multiple days), seasonal and throughout the lifetime. Using data from implanted chronic EEG that records long-term epileptic brain activity, converging evidence shows that in many patients, children and adults alike, these fluctuations in seizure risk are rhythmic and can contribute to the accurate forecasting of seizures. At the dawn of a new era of personalized epileptology, this translational talk will focus on the clinical relevance of rhythms in epilepsy and discuss potential mechanisms.

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Telemedicine programs are particularly suited to evaluating patients with Parkinson's disease (PD) and other movement disorders, primarily because much of the physical exam findings are visual. Telemedicine uses information and communication technologist (ICTs) to overcome geographical barriers and increase access to healthcare services, and it is particularly beneficial for rural and underserved communities, groups that traditionally suffer from a lack of access to healthcare. There is a growing evidence of the feasibility of telemedicine, cost and time savings, patients’ and physicians’ satisfaction, and its outcome and impact on patients’ morbidity and quality of life. In addition, given the unusual current situation with the COVID-19 pandemic, telemedicine has offered the opportunity to address the ongoing healthcare needs of patients with PD, to reduce in-person clinic visits and human exposures (among healthcare workers and patients) to a range of infectious diseases including COVID-19. However, there are still several challenges to widespread implementation of telemedicine, including the limited performance of parts of the neurological exam, limited technological savvy, fear of loss of a personal connection, or uneasiness about communicating sensitive information. On the other hand, while we are facing the new wave of COVID-19 pandemic, patients and clinicians are gaining increasing experience with telemedicine, facilitating the equity of access to specialized multidisciplinary care for PD. In this session, we will review the current state and future directions of telemedicine for PD and other movement disorders from a global perspective.