Objective: Improving education and care in movement disorders through telemedicine.

Background: In 2012, the Movement Disorders Society launched a telemedicine project to enable professionals from lower resource environments to consult movement disorder experts. In many countries, neurological expertise and care is limited or absent. As opposed to neurology training capacity elsewhere in Africa, there is a longer way to go for most Eastern and Central African countries. For instance in Tanzania, there is 1 practicing neurologist per 10 million population (1). The MDS broadband telemedicine project kindly offered their consultation, and a collaboration was born. The approach however, was slightly different from areas with better neurologist coverage. The neurologists working from Northern Tanzania operated their own telemedicine “hub”, supporting a number of Eastern and Central African neurologists, as well as medical and pediatric specialists within Tanzania.

Methods: From 2015 onward, encrypted and anonymised clinical consultations (video, text documents and image files) from across Eastern and Central Africa are being forwarded to the ACMD Movement Disorders Telemedicine server in Canada (broadband/WhatsApp). Through the referral centre’s own protocol or through the Telemedicine form, informed consent was obtained. Patient characteristics and diagnosis were tabulated.

Results: Nineteen patients were assessed, most of whom Tanzanian. Some referrals, however, came from as far as Rwanda, Malawi and Zanzibar. Only two referrals were from other neurologists. Diagnosis, patient characteristics and special features are highlighted in a table. Diagnostic reports were used as feedback to the referring doctor and teaching.

Conclusions: -A large diversity of movement disorders was presented to the Telemedicine Task Force. -Parkinson’s Disease queries were not amongst them. Due to minimal availability and affordability of dopaminergic medication and the advanced stage upon presentation, little doubt about the diagnosis remained. -The analysis by the MDS telemedicine consultants was instructive for referring neurologists and physicians. -This colourful glossary of African Neurology will also enrich the consulted Task Force members’ experience. We herewith suggest constructing a database for future reference.

References: 1. Dekker MCJ, Urasa SJ, Howlett WP. Neurological letter from Kilimanjaro. Pract Neurol 2017;17:412–6.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/asynchronous-consultation-in-movement-disorders-the-east-africa-hub/