Acute Seizures Occurring in Association With SARS-CoV-2

Hwang, Sean; Ballout, Ahmad A; Mirza, Usman; Sonti, Anup N.; Husain, Arif; Kirsch, Claudia; Kuzniecky, Ruben; Najjar, Souhel

doi:10.3389/fneur.2020.576329

Cited by 12 publications

(22 citation statements)

References 49 publications

(73 reference statements)

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“…Thirty-nine articles (24 case reports and 15 case series, with individual patient data available for 47 patients) fulfilling the selection criteria were finally included ( Fig. 1 ) [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] . According to Newcastle-Ottawa Quality Assessment Scale (NOS), six papers (6/39) were scored 2, sixteen papers (13/39) were scored 3, twenty-two papers (19/38) were scored 4, and one paper (1/38) was scored 5 (score results for each study are provided in Supp.Tab.3 ).…”

Section: Resultsmentioning

confidence: 99%

“…Thirteen patients had complete recovery at follow-up, whereas one patient had a persisting dysexecutive syndrome [36] , and a moderate persistent cognitive deficit with bilateral proximal weakness in a further patient [37] .…”

Section: Discussionmentioning

confidence: 99%

“…A follow-up EEG was performed in 5 patients (10.6%). EEG findings were normal in 2 patients, whereas the others showed “GRDA” [26] , “GRDA and GPDs” [26] , or “transitioning to moderate background, slowing with intermittent left temporal sharp waves” [37] .…”

Section: Eeg Findingsmentioning

confidence: 99%

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Status epilepticus and COVID-19: A systematic review

Dono

Nucera

Lanzone

et al. 2021

Epilepsy & Behavior

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Purpose In March 2020, the World Health Organization declared the SARS-CoV-2 infection-related coronavirus Disease (COVID-19) a pandemic. During the first and second waves of the pandemic spread, there have been several reports of COVID-19-associated neurological manifestations, including acute seizures and status epilepticus (SE). In this systematic review, we summarized the available data on clinical features, diagnosis, and therapy of COVID-19-related SE. Methods We performed a systematic search of the literature to identify data on demographics, clinical, neurophysiological, and neuroradiological data of patients with COVID-19-related SE. We used regression models (linear or logistic) with a stepwise forward method to identify features associated with mortality or severity of SE. Results Thirty-nine articles were included with a total of 47 cases of SE associated with COVID-19. Age, time between the acute respiratory phase of SARS-CoV-2 infection and SE onset, and hospitalization correlated with a higher SE severity as assessed by quantitative validated scales. Conclusions SE can be a neurological manifestation of SARS-CoV-2 infection. Although a possible association between SE and COVID-19 has been reported, the exact mechanisms are still not fully understood. Systemic inflammatory syndrome due to cytokine release could play a role in COVID-19-related SE.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Status epilepticus and COVID-19: A systematic review

Dono

Nucera

Lanzone

et al. 2021

Epilepsy & Behavior

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“…15,17 Patients with COVID-19-related encephalopathy may also present with new-onset seizures, either focal or generalized, convulsive or non-convulsive, including status epilepticus. [44][45][46] Headache is another frequently reported symptom in COVID-19 and ICANS, occurring in 28% and 55% of patients, respectively. 16,47 Even though this is a non-specific manifestation and its features have been poorly described in both disorders, it may represent an early manifestation of CNS involvement.…”

Section: Cytokine Storm Disordersmentioning

confidence: 99%

Brain dysfunction in COVID‐19 and CAR‐T therapy: cytokine storm‐associated encephalopathy

Pensato

Muccioli

Cani

et al. 2021

Ann Clin Transl Neurol

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Objective Many neurological manifestations are associated with COVID‐19, including a distinct form of encephalopathy related to cytokine storm, the acute systemic inflammatory syndrome present in a subgroup of COVID‐19 patients. Cytokine storm is also associated with immune effector cell‐associated neurotoxicity syndrome (ICANS), a complication of chimeric antigen receptor T‐cell (CAR‐T) therapy, a highly effective treatment for refractory hematological malignancies. We investigated whether COVID‐19‐related encephalopathy, ICANS, and other encephalopathies associated with cytokine storm, share clinical and investigative findings. Methods Narrative literature review. Results Comparisons between COVID‐19‐related encephalopathy and ICANS revealed several overlapping features. Clinically, these included dysexecutive syndrome, language disturbances, akinetic mutism and delirium. EEG showed a prevalence of frontal abnormalities. Brain MRI was often unrevealing. CSF elevated cytokine levels have been reported. A direct correlation between cytokine storm intensity and severity of neurological manifestations has been shown for both conditions. Clinical recovery occurred spontaneously or following immunotherapies in most of the patients. Similar clinical and investigative features were also reported in other encephalopathies associated with cytokine storm, such as hemophagocytic lymphohistiocytosis, sepsis, and febrile infection‐associated encephalopathies. Interpretation COVID‐19‐related encephalopathy and ICANS are characterized by a predominant electro‐clinical frontal lobe dysfunction and share several features with other encephalopathies associated with cytokine storm, which may represent the common denominator of a clinical spectrum of neurological disorders. Therefore, we propose a unifying definition of cytokine storm‐associated encephalopathy (CySE), and its diagnostic criteria.

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“…An infected patient with a history of diabetes, hypertension, and on kidney dialysis without known seizures developed multiple episodes of new-onset seizures during infection and died shortly after the onset of seizure [ 27 ]. Many other cases have subsequently been reported of new-onset seizures in COVID-19 patients [ 28 , 29 ]. Whether such seizures are secondary to multi-organ failure or intravascular coagulopathy-related brain injury is still not clear.…”

Section: Central Nervous System Manifestationsmentioning

confidence: 99%

COVID-19 associated nervous system manifestations

2022

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The novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a global pandemic in the last year. Along with major respiratory distress, a myriad of neurological manifestations was also reported to be associated with COVID-19 patients. These cases indicate that SARS-CoV-2 can be considered as an opportunistic pathogen of the brain. SARS-CoV-2 enters the brain through the olfactory bulb, retrograde axonal transport from peripheral nerve endings, or via hematogenous or lymphatic routes. Notably, COVID-19 infection can cause or even present with different neurological features including encephalopathy, impaired consciousness, confusion, agitation, seizure, ataxia, headache, anosmia, ageusia, neuropathies, and neurodegenerative diseases. In this paper, we provide a brief review of observed neurological manifestations associated with COVID-19.

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Acute Seizures Occurring in Association With SARS-CoV-2

Cited by 12 publications

References 49 publications

Status epilepticus and COVID-19: A systematic review

Status epilepticus and COVID-19: A systematic review

Brain dysfunction in COVID‐19 and CAR‐T therapy: cytokine storm‐associated encephalopathy

COVID-19 associated nervous system manifestations

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