Authors :
Ji-Ye Jeon, MD – Kyungpook National University School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, Korea; Ho-Won Lee, MD, Ph.D – Kyungpook National University School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, Korea
Rationale: Coronavirus disease 2019 (COVID-19) is a new human pathogen that causes the respiratory syndrome.
The major symptoms in infected people include fever, cough, pain, chills, and loss of smell or taste. Covid-19 can also cause neurological symptoms such as tingling in the hands and feet, vertigo, delirium, ischemic and hemorrhagic stroke, and seizures. The authors report a case series of COVID-19 induced seizures in a tertiary medical center in Korea.
Methods: Electronic medical records of new-onset seizures in patients with COVID-19 patients.
Results: A total of 5,690 patients with confirmed COVID-19 were admitted to our hospital during the study period (2020 march to 2022 may). Out of these, 10 patients (0.17%) developed new-onset seizures during hospitalization. Patients’ ages ranged from 29 to 83 years, and three of the ten patients were older than 60 years. Seven patients were men. Three patients were admitted to the intensive care unit (ICU). The duration from COVID-19 diagnosis to seizure onset ranged from 1 to 20 days (mean duration: 7.2 ± 8.5 days). Seven patients were purposed magnetic resonance imaging (MRI) of the brain, and two of seven patients showed old hemorrhagic lesions. One patient had myoclonic status epilepticus, three patients suffered multiple seizure. Seven patients underwent EEG, two patients showed generalized slowing, one patient showed regional spike, one patient showed generalized polyspike and wave, and three patients showed normal EEG. All patients were receiving anticonvulsants or intravenous midazolam. Three patients died due to COVID-19 pneumonia or sepsis.
Conclusions: New-onset seizures are a rare complication of COVID-19 but may occur commonly in critically ill patients. It is still unclear how Covid-19 trigger the development of acute symptomatic seizure, direct brain invasion of SARS-CoV-2 may be related to the occurrent of seizures in COVID-10 patients with seizure. Further research is needed to probe and study the exact mechanism at a more molecular level.
Funding: This research did not receive any specific grants from funding agencies in the public, commercial, or not-for-profit sectors.