Highlights:
- When seeing a neurology clinician for the first time, being seen virtually versus in-person made no difference in how soon people needed more care.
- Researchers analyzed over 16,000 matched patient visits during the COVID-19 pandemic and found a quarter of patients had a follow-up appointment within 90 days, regardless of visit type.
- Emergency department visits and hospitalizations within 90 days also did not differ between those who had virtual or in-person first visit.
- Researchers say the findings suggest in general, virtual visits are appropriate for a first neurological exam across a range of conditions.
- Differences emerged based on condition: in-person visits were associated with higher 90-day follow-up clinic visit rate for dementia, while virtual visits were associated with higher follow-up clinic visit rate for Parkinson disease, multiple sclerosis and headache.
- In stroke, there were more hospitalizations within 90 days following a virtual visit.
- The study occurred during the COVID-19 pandemic, so researchers say more studies are needed since people may now seek medical care differently. More studies are also needed to better understand differences between conditions.
MINNEAPOLIS — For people who see a neurology clinician for the first time, a new study has found that being seen virtually vs. in-person made no difference in how soon they needed more care. The study was published April 22, 2026, in Neurology ® , the medical journal of the American Academy of Neurology .
"While telemedicine has been shown to improve access to care for people in rural areas and for those without transportation, and telemedicine has received high satisfaction scores from both clinicians and patients, not a lot of research has been done on how effective virtual visits are compared to in-person visits, especially for new neurology patients," said study author Chloé E. Hill, MD, of the University of Michigan in Ann Arbor and a member of the American Academy of Neurology. "We looked at how often people had a follow-up neurology clinic visit or needed to go to the emergency department or the hospital within three months after their first visit to see if virtual visits led to a need for more follow-up evaluations or more serious problems than in-person visits."
For the study, researchers reviewed electronic medical record data from three academic health systems to identify first-time patient visits with a neurology clinician between September 2020 and December 2021, during the COVID-19 pandemic.
Researchers matched 8,202 virtual visits to 8,202 in-person visits. Participants were matched for factors such as age, sex and previous health care use. They were then grouped into categories based on the reason for their visit, such as dementia, epilepsy, headache, peripheral neuropathy, Parkinson's disease, multiple sclerosis, stroke, sleep disorders and other conditions.
Comparing virtual visits and in-person visits, researchers found no difference in follow-up visits to a neurology clinic, either virtual or in-person, with a quarter of people having a second visit within 90 days.
Visits to the emergency department and hospitalizations were also similar within 90 days.
When looking at individual conditions, the 90-day clinic visit follow-up rate was higher after in-person visits for dementia, while 30- and 90-day follow-up was higher after virtual visits for Parkinson's disease and multiple sclerosis, and 90-day follow-up was higher after virtual visits for headache. In stroke, there were more hospitalizations within 90 days following a virtual visit.
"Our results suggest that virtual visits are appropriate for an initial neurologic evaluation across a range of conditions," said Hill. "We found that neurology patients with initial virtual visits do not typically experience higher rates of trips to the emergency department or hospitalizations. Future research should investigate more fully if people with different conditions may benefit more from one particular type of visit."
A limitation of the study was that the data was from the early months of the COVID-19 pandemic before a vaccine was available and when care‑seeking behavior may have been affected. Hill said more recent years of data may show different patterns of medical care use and should be analyzed in future studies.
The study was supported by the American Academy of Neurology.
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The American Academy of Neurology is the leading voice in brain health. As the world's largest association of neurologists and neuroscience professionals with more than 44,000 members, the AAN provides access to the latest news, science and research affecting neurology for patients, caregivers, physicians and professionals alike. The AAN's mission is to enhance member career fulfillment and promote brain health for all. A neurologist is a doctor who specializes in the diagnosis, care and treatment of brain, spinal cord and nervous system diseases such as Alzheimer's disease, stroke, concussion, epilepsy, Parkinson's disease, multiple sclerosis, headache and migraine.
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