Objectives/Aims Research suggests that patients and neurologists are generally satisfied with the use of teleconsultations in the treatment of seizure disorders. However, to gain a full picture of the relative merits of face-to-face and teleconsultations, we need to compare them empirically using recordings of real-life neurologist-patient interactions. Studies from other areas of medicine suggest that consultations can be compared on three levels of increasing detail:

1. Abstract level: comparing the duration of consultations.

2. Structural level: comparing how talking time is distributed between the doctor and patient/companion.

3. Detailed level: comparing what is said and how it is said.

The aim of this research is to compare face-to-face and teleconsultations in the seizure clinic based on their duration, distribution of talk, and the number of questions asked by patients.

Methods Statistical comparison between and transcripts of 34 telephone consultations (recorded in 2021) and 56 face-to-face consultations (recorded in 2013).

Results There was no significant difference in duration between face-to-face and telephone consultations (median of 16.5 versus 16.2 minutes). Likewise, there was no significant difference in the ratio of neurologist versus patient/companion talk between modalities (55% vs. 45% and 54% vs. 46% respectively). However, patients/companions asked more questions in face-to-face than telephone consultations (median 3 vs. 1, p < 0.05).

Conclusions From a broad perspective, face-to-face and teleconsultations in the seizure clinic are similar, lasting for roughly the same amount of time with a similar distribution of talk between parties. However, more detailed analysis reveals potentially consequential differences, suggesting that patients may find it more difficult to ask questions in telephone encounters. Future research should explore other such differences.