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BACKGROUND: The new coronavirus, known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) owing to its similarity to the previous severe acute respiratory syndrome (SARS), is characterized by causing, in most patients, nonspecific symptoms similar to those of the common flu. It has been reported that many coronavirus disease 2019 (COVID-19) patients presented neurological symptoms that involve the central and peripheral nervous systems. In addition, there have been several reports of patients who presented Guillain-Barré syndrome related to  COVID-19 , with sensory and motor compromise in the extremities. CASE PRESENTATION: In this report, we describe a rare case of Guillain-Barré syndrome in a 50-year-old Hispanic male with bilateral facial palsy as the only neurological manifestation, following SARS-CoV-2 infection. A complete neurophysiological study showed severe axonal neuropathy of the right and left facial nerves. CONCLUSION: Regardless of severity, clinicians must to be aware of any neurological manifestation generated by COVID-19 and start performing more neurophysiological tests to determine if the infection induces an axonal, myelin, or mixed involvement of the peripheral nervous system.

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False lateralization of ictal onset by scalp electroencephalogram (EEG) is an infrequent entity that has been reported in patients with mesial temporal lobe epilepsy associated with hippocampal sclerosis (HS). In these cases, a tendency for rapid seizures that spread through the frontal-limbic system and hippocampal commissural pathways to the contralateral hemisphere has been proposed. Cerebral cavernous malformations (CCMs), which constitute a collection of abnormally configured small blood vessels with irregular structures, is a well-defined epilepsy-associated pathology. Their primary association with seizures might be explained either as a result of physiological changes affecting the cerebral cortex immediately surrounding the CCM (an epileptogenic mechanism that is relevant for both, temporal and extratemporal lesions) or as a result of promoting epileptogenicity in remote but anatomo-functionally connected brain regions, a mechanism that is particularly relevant for temporal lobe lesions. To date, there have been only two publications on falsely lateralizing ictal onsets by EEG in temporal cavernoma, but not in other regions. Here, we report a rare case of apparent false lateralization of ictal onset by scalp EEG in a patient with a left medial frontal gyrus cavernoma (supplementary motor area), and discuss some relevant pathophysiological mechanisms of false lateralization.

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RESUMEN La encefalopatía es una manifestación neurológica frecuente en los pacientes en UCI con Covid-19. Es importante realizar un adecuado diagnóstico diferencial con el estado epiléptico no convulsivo, para poder optimizar su cuidado y pronóstico. El uso del video-electroencefalograma (VEEG) bajo adecuadas normas de bioseguridad, permite realizar un adecuado diagnóstico del estado epiléptico, disminuyendo el numero de ingresos innecesarios a la Unidad de Cuidado Intensivo, y el tiempo de sedación con anestésicos. La telemedicina para los pacientes con epilepsia ha demostrado ser una herramienta útil, al no mostrar inferioridad en comparación con las visitas cara a cara habituales en términos de diferencia significativa en el número de las crisis, hospitalizaciones, visitas a la sala de emergencias o cumplimiento de medicamentos.

SUMMARY: Encephalopathy is a frequent neurological manifestation in ICU patients with COVID-19. It is important to make an accurate differential diagnosis with non-convulsive epileptic status, in order to optimize the management and prognosis. The use of Video-EEG monitoring assuring biosecurity standards, allows an adequate diagnosis of epileptic status, reducing the number of unnecessary admissions to the intensive care unit, sedation time and anesthetics use. The use of telemedicine in patients with epilepsy has proven to be a useful tool, compared to standard outpatient visits in terms of number of seizures, admissions, emergency visits, or adherence to the medication.

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RESUMEN INTRODUCCIÓN: El estado epiléptico (EE) es una condición ocasionada por la falla en los mecanismos de supresión de las crisis epilépticas. Se considera como una urgencia neurológica y obliga al profesional de la salud a conocer las características de presentación para poder estabilizar al paciente. La mortalidad varía entre el 2 % y el 50 % según el grupo etario. OBJETIVO: Construir una serie de sugerencias para el tratamiento del EE, como resultado del consenso por común acuerdo de expertos en epilepsia, teniendo en cuenta el contexto colombiano. MÉTODOS: Se llevó a cabo un consenso formal de expertos con 16 neurólogos-epileptólogos de adultos y niños. Las preguntas y sugerencias fueron revisadas en dos fases, donde fueron calificadas y consensuadas por los participantes. RESULTADOS: Se evaluaron 15 preguntas, con sus respectivas sugerencias sobre el manejo del estado epiléptico, se tuvieron en cuenta referencias bibliográficas relevantes consideradas por los expertos y de acuerdo con el contexto colombiano. CONCLUSIONES: Los resultados de este consenso presentan una serie de sugerencias para el tratamiento del estado epiléptico tanto en los primeros niveles de atención como en los de alta complejidad para mejorar el pronóstico del paciente, de acuerdo con el contexto colombiano.

SUMMARY INTRODUCTION: Status epilepticus is a condition caused by failure in the mechanisms of suppression of epileptic seizures. It is considered a neurological emergency, and mortality varies between 2 % to 50 % according to the age group. Due to the above, it is relevant that health professionals know the characteristics of SE in order to stabilize the patient. OBJECTIVE: To define a series of propositions for the treatment of SE, as a result of consensus by common agreement of experts in epilepsy, taking into account the Colombian context. METHODS: A formal consensus of experts was carried out with 16 adult and pediatric neurologists-epilep-tologists. The questions and propositions were reviewed in two phases, where they were graded and agreed by the participants. RESULTS: Fifteen questions were evaluated on the management of status epilepticus. Relevant bibliographic references were considered by the experts according to the Colombian context. CONCLUSIONS: As results of this consensus we present a series of propositions for the treatment of status epilepticus for the primary level of care and high complexity level of care in order to improve the patient's prognosis, according to the Colombian context.

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Introducción: la gran demanda de pacientes en servicios de consulta especializada de neurología y la pocaoferta de profesionales entrenados y médicos especialistas, principalmente en zonas aisladas por circunstanciasgeográficas o políticas, nos obligan a buscar nuevos recursos como la telemedicina a fin de mejorar el tiempode consulta.Objetivo: explorar el grado de satisfacción del neurólogo y de los pacientes con epilepsia en una consulta portelemedicina en el Hospital San José de Arjona con conexión al Hospital de San José en Bogotá.Materiales y métodos: estudio observacional prospectivo en pacientes mayores de 15 años con diagnósticode epilepsia. Se diligenció el instrumento de evaluación de satisfacción del neurólogo y de los pacientes, quecontiene una escala aplicada en Canadá, la cual consta de diecinueve preguntas, validadas en Colombia graciasa la prueba piloto realizada en el 2012 por nuestro Grupo de Neurología y Telemedicina, implementada paraevaluar la satisfacción de los pacientes en la consulta de epilepsia por telemedicina.Conclusión: según los resultados de este estudio, podemos concluir que tanto los pacientes como los neurólogosque realizaron la consulta guiada por telemedicina están satisfechos con el uso de esta herramienta,siendo este método una alternativa para la atención en salud.

Introduction: the high demand for specialist neurology services and the short supply of trained specialists, mainly in remote areas for geographical or political circumstances, force us to look for new resources such as telemedicine to improve the offer of this services.Objective: to explore the degree of neurologist and patients satisfation with epilepsy telemedicine clinic at the Hospital of Arjona in Bolivar with connection to San José Hospital in Bogotá.Materials and Methods: a prospective observational study in patients older than 15 years diagnosed with epilepsy. The assessment tool neurologist and satisfaction of patients, containing a scale used in Canada, which consists of nineteen questions, validated to spanish through the pilot test in 2012 by our group of Neurology and Telemedicine, implemented to evaluate the satisfaction of patients with epilepsy in a neurology clinic through telemedicine. In addition, this questionnaire is designed according to Thurstone scale consisting of five possible answers, which in order are: "Strongly disagree", "Disagree", "Neutral", "Agree", "Strongly agree". The recruitment of patients was done through posters alluding to study one to two months before the survey.Results: 39 patients, of whom 51.3% were women, were assessed with an average age 35 years ± 16. The pzatient satisfaction with telemedicine clinic was rated "strongly agree" in 83.8%, 91.9% see telemedicine as an acceptable way to receive health care and 94.6% consider it saves more money compared to conventional clinic. Both neurologists satisfaction with telemedicine is distributed evenly between "strongly agree" and "agree".Conclusion: with the results of this study, we can conclude that patients and neurologist are satisfied with the use of this resource, this method being an alternative for health care.

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