We present an interesting case of acute ischemic stroke in a 26-year-old patient with coronavirus disease 2019, who presented to the hospital initially with headache, vomiting, and right-sided numbness and tingling. The initial workup was negative, including computed tomography (CT) of the head without contrast and CT angiography of the head and neck with no acute abnormalities. The patient was diagnosed with migraine and discharged from the emergency department. The patient developed worsening symptoms at home in the form of increasing right-sided dysmetria and weakness, gait ataxia, and dysarthria, prompting her to return to the emergency room. Magnetic resonance imaging of the brain was performed and was significant for right-sided acute ischemic cerebellar stroke, with also the involvement of the right cerebellar peduncle. Echocardiogram with a bubble study demonstrated patent foramen ovale. The patient was treated with standard guidelines for stroke.

Neurological manifestations are common in coronavirus disease 2019 (COVID-19) patients. We present three cases of COVID-19 patients with seizures. Two patients had a history of seizures but very well controlled. They presented with seizure activity likely triggered by COVID-19. The third patient had no history of seizures and presented with new onset of seizure activity. All these patients were routinely screened for COVID-19 on admission and tested positive on nasopharyngeal real-time reverse transcriptase-polymerase chain reaction (rRT-PCR). None of these patients had respiratory symptoms. Electroencephalography (EEG) was abnormal in all three patients. All these patients recovered and were discharged in a stable condition.

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