{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T11:11:21Z","timestamp":1753182681278},"reference-count":0,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>Telemedicine has been rapidly adopted due to COVID-19. In the earliest days, most screenings were performed by primary care\/internal medicine consultants; referrals to subspecialists were minimized. Now, as the pandemic has evolved over 6 months, secondary telemedicine consultations should be limited, and earlier involvement of appropriate subspecialists should be reconsidered to optimize patient management.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Case Description: <\/jats:title>\n<jats:p>An older individual spoke to an on-call general medical physician with the chief complaint of the acute onset of low back pain after moderately strenuous activity, with severe unilateral radiculopathy. The telemedicine physician recommended a non-steroidal. anti-inflammatory agent without any specific recommendations regarding follow-up. A few days later, with progression of unilateral pain and numbness, a second telemedicine medical consultation was performed; a Medrol dose pack and muscle relaxant were now recommended, again without any follow-up recommendations. Days later, with increased unilateral pain\/ near anesthesia in the foot, the patient was seen by a spinal surgeon who found; unilateral SLR positive at 20 degrees, a 0\/5 foot drop, loss of the Achilles Response, and decreased pin appreciation in the L5 distribution. The patient\u2019s emergent lumbar MR showed a large unilateral disc herniation with inferior migration at the appropriate level, warranting surgical consideration.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>Here, we emphasized several points. First, telemedicine may be adequate for the initial screening, but further complaints would be better evaluated in person by either a medical or surgical subspecialist; here, both could have recognized the very clear unilateral foot drop. Second, the patient should have had a scheduled follow-up in-person consultation. Third, appropriate diagnostic studies should have been ordered at the time of the second telemedicine consultation to establish the correct diagnosis and direct treatment.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_584_2020","type":"journal-article","created":{"date-parts":[[2020,9,18]],"date-time":"2020-09-18T06:29:14Z","timestamp":1600410554000},"page":"301","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Case Report (Precis): Two Telemedicine Consultants Miss Foot Drop: When To See Patients in Person"],"prefix":"10.25259","volume":"11","author":[{"given":"Nancy E.","family":"Epstein","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2020,9,18]]},"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/case-report-precis-two-telemedicine-consultants-miss-foot-drop-when-to-see-patients-in-person\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/case-report-precis-two-telemedicine-consultants-miss-foot-drop-when-to-see-patients-in-person\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,18]],"date-time":"2020-09-18T06:29:14Z","timestamp":1600410554000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/case-report-precis-two-telemedicine-consultants-miss-foot-drop-when-to-see-patients-in-person\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,18]]},"references-count":0,"alternative-id":["10.25259\/SNI_584_2020"],"URL":"https:\/\/doi.org\/10.25259\/sni_584_2020","relation":{},"ISSN":["2152-7806"],"issn-type":[{"value":"2152-7806","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,18]]},"article-number":"301"}}