Rationale:
eurological manifestations are increasingly associated with COVID-19. However, an association of seizures with COVID-19 has not been established. The aim of this study is to determine the prevalence of epileptiform activity and assess the risk of seizures in patients with COVID-19.
Method:
We retrospectively reviewed the medical records from 32 consecutive non-epileptic patients who tested positive for SARS-CoV-2 and underwent EEG studies between March 1, 2020 and May 27, 2020. Data were extracted about demographics, clinical history, neuroimaging and EEG features.
Results:
The mean age was 61.9 ± 17.8 years (mean ± SD, range: 18 to 91). Eighteen patients were male and 14 were female. Acute symptomatic seizures were observed clinically in 4 (12.5%) patients. Normal EEG background frequency (8-10Hz) was observed in 6 (18.8%) patients. Diffuse slowing of EEG background was observed in 26 (81.3%) patients. Ictal-interictal continuum (IIC) patterns were observed in 8 (25%) patients. Interictal epileptiform discharges (IEDs) were observed in 6 (18.8%) patients, and electrographic seizures were observed in 3 (9.4%) patients. Two patients progressed to status epilepticus. In one patient, brain MRI showed extensive areas of T2/Flair hyperintensity with minimal diffusion restriction, suggestive of encephalitis.
Conclusion:
These findings demonstrate that there is a substantial risk for acute symptomatic seizures in patients with COVID-19. Although the seizure etiologies are likely heterogeneous, encephalitis might be contributory.
Funding:
:n/a
FIGURES
Figure 1