Editorial: Consequences of the COVID-19 Pandemic on Care for Neurological Conditions

Department of Neurology, Hospital Clínico San Carlos, Health Research Institute “San Carlos” (IdISCC), Universidad Complutense de Madrid, Madrid, Spain, Division of Neurology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City, Taiwan, Department of Neurology, Tainan Sin Lau Hospital, Tainan, Taiwan, Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan, Department of Cognitive Neurology, Neuropsychiatry and Neuropsychology, Instituto Neurológico Fleni, Buenos Aires, Argentina


STUDIES ON EPILEPSY
The treatment of patients with epilepsy is another of the topics examined in the Research Topic. Mostacci et al. reviewed the literature regarding the impact of the pandemic on the health of patients with epilepsy, and conducted a survey regarding this topic. Although most patients did not report a significant change, clinical worsening was detected in a proportion of changes and was associated with sleep disorders or limited access to healthcare, among other factors. Lanzone et al. conducted a study evaluating the impact of lockdown in patients with epilepsy. In this case, the survey was analyzed with a text mining approach. Patients with epilepsy used different kinds of words, suggesting a different reaction to the lockdown compared with controls, which may be important in the follow-up and treatment of these patients during traumatic or stressful events.
Telemedicine has become very widespread in epilepsy care since the pandemic. Accordingly, a decision-making tree to manage patients with epilepsy was proposed (Kuroda).

STUDIES ON MULTIPLE SCLEROSIS
Patients with multiple sclerosis (MS) were regarded as a highrisk population due to the potential immunosuppressive effect of several treatments used in the disease. In a study by the Portuguese Multiple Sclerosis Study Group a consensus was obtained using a Delphi methodology about the implementation of several changes in the management in the context of the pandemic (Cerqueira et al.).

STUDIES ON NEUROMUSCULAR DISORDERS
Patients with neuromuscular disorders were at higher risk of COVID-19 due to the frequent respiratory involvement and some immunosuppressive therapies. In this regard, several studies evaluated the impact of the pandemic and the SARS-CoV-2 infection in patients with neuromuscular disorders. Katyal et al., reviewed the potential neuromuscular complications of COVID-19, such as Guillain-Barre syndrome. In two studies by Bertran Recasens and Rubio and Tseng and Chen, the authors proposed recommendations for the management of patients with neuromuscular disorders during the pandemic or during COVID-19, and evaluated the impact of the pandemic on these patients.

STUDIES ON HEADACHE
Headache is one of the most frequent symptoms during COVID-19. However, primary headaches are also influenced by environmental factors. This topic was examined by Delussi et al., in a cross-sectional study from the Italian National Headache Registry, in which changes in migraine during the quarantine were investigated. According to the study by Dallavale et al., in children and adolescents, there was a mild improvement of migraine symptoms. Furthermore, Planchuelo-Gómez et al., tried to characterize the headache phenotypes in COVID-19 and link these features with inflammatory biomarkers.

STUDIES ON NEUROPEDIATRICS
SARS-CoV-2 also affects children, although to a lesser extent than adults. In the article by Boronat, the evidence about neurological symptoms and complications in children was reviewed. Compared with adults, neurological complications were less frequent. However, a multisystem inflammatory syndrome can occur, with the development of encephalopathy as the most frequent clinical manifestation. Furthermore, in this article, a review of the changes in the care of children with neurological disorders (e.g., cerebral palsy, epilepsy, attention deficit and hyperactivity disorder, etc.) was presented. Other collateral problems in children have been the closure of schools, lack of free time outdoors, and financial insecurity.

CONCLUSIONS
In this Research Topic, the authors have presented important experiences and solutions to the changes generated by the COVID-19 pandemic in neurological care. Most of the studies were conducted during the first stages of the COVID-19 to face many of the challenges that had arisen, including the lockdown and quarantines, safety concerns because of high transmissibility, and risks of COVID-19 in patients with neurological disorders. As in other crises, the lessons learned should be applied for the future benefit of patients and the healthcare system during the COVID-19 pandemic, and probably afterward. Some changes in neurological care, such as safety protocols or implementation of teletherapy, may be helpful and relevant in daily practice (4,5). How the current pandemic will give rise to long-term changes in neurological assistance, and the convenience of these changes, should be evaluated in the future.

AUTHOR CONTRIBUTIONS
JM-G wrote the first draft of the manuscript. RA wrote parts of the manuscript. All authors contributed to manuscript revision, read, and approved the submitted version.