Cerebrospinal fluid findings in patients with seizure in the setting of COVID-19: A review of the literature

Carroll, Elizabeth; Melmed, Kara; Frontera, Jennifer A.; Placantonakis, Dimitris G.; Galetta, Steven; Balcer, Laura J.; Lewis, Ariane

doi:10.1016/j.seizure.2021.05.003

Cited by 18 publications

(19 citation statements)

References 80 publications

(328 reference statements)

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“…This finding confirmed the hypothesis that SARS-CoV-2 can infiltrate the CNS, but the presence of SARS-CoV-2 was not associated with the severity of neuropathological changes, which occurred similarly in patients without SARS-CoV-2 brain infiltration [5]. On the other hand, the detection of SARS-CoV-2 in cerebrospinal fluid (CSF) of patients with seizures and COVID-19 disease is uncommon [6].…”

Section: Introductionsupporting

confidence: 70%

Ictogenesis of viral pneumonia: A comparison between SARS-CoV-2 and H1N1/H3N2

Milano

Turco

Pizzanelli

et al. 2022

Epilepsy & Behavior

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Section: Introductionsupporting

confidence: 70%

Ictogenesis of viral pneumonia: A comparison between SARS-CoV-2 and H1N1/H3N2

Milano

Turco

Pizzanelli

et al. 2022

Epilepsy & Behavior

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“… 10 17 However, detection of SARS-CoV-2 in the CSF of patients with seizures who have COVID-19 is uncommon (13%), and even when it is present, the significance of this finding is unknown. 18 …”

Section: Discussionmentioning

confidence: 99%

New-Onset Seizures in Patients With COVID-19: A Case Series From a Single Public Hospital in Korea

Cho

Kim

2022

J Korean Med Sci

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Seizure is an uncommon complication of coronavirus disease 2019 (COVID-19). The frequency and characteristics of new-onset seizures in hospitalized patients with COVID-19 were investigated. Of a total of 1,487 patients with confirmed COVID-19, six (0.4%) developed new-onset seizures. All six had severe or critical COVID-19 requiring intensive care and mechanical ventilation or high-flow oxygen therapy. Among COVID-19 patients admitted to the intensive care unit (n = 169), the incidence of new-onset seizures was 3.6%. Underlying structural lesions (acute infarction and remote hemorrhage), hypoxia, sepsis, and metabolic derangements were associated with the development of seizures. Of the six patients, three patients died, and, at the time of discharge, one patient had a severe disability, while the remaining two were well recovered.

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Section: Csf Findings In Patients With Covid-19 and Seizuresmentioning

confidence: 99%

“…A systematic review of 69 patients with seizures in the setting of COVID-19 who underwent CSF testing showed that only 13% had positive CSF SARS-CoV-2 PCR [62]. Hence detection of SARS-CoV-2 in CSF of patients with seizures is uncommon, and seizures in patients with COVID-19 are unlikely to be due to direct viral invasion of the brain [62]. This may lend additional support to the theory that seizures and epileptogenesis in patients with COVID-19 may occur because of neuroinflammatory reactions to the virus rather than direct CNS invasion.…”

Section: Csf Findings In Patients With Covid-19 and Seizuresmentioning

confidence: 99%

SARS-CoV-2 infection and seizures: the perfect storm

Tsai¹,

Wilson²,

Rubiños³

2022

J. Integr. Neurosci.

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Seizures have been increasingly identified as a neurologic manifestation of coronavirus disease 2019 (COVID-19) infection. They may be symptomatic due to systemic infections, as a result of direct central nervous system (CNS) invasion, or occur in response to inflammatory reactions to the virus. It is possible that proinflammatory molecules released in response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can lead to hyperexcitability and epileptogenesis, similar to infections caused by other neurotrophic viruses. Cerebral spinal fluid (CSF) in patients with COVID-19 and seizures is negative for SARS-CoV-2 (PCR) in the majority of patients, but has been found to be positive for proinflammatory molecules like IL-6, IL-8, and anti-neuronal autoantibodies. Electroencephalogram (EEG) in COVID-19 patients are nonspecific. However, in the encephalopathic and critically ill subpopulation, EEG is essential in detecting nonconvulsive seizures and status epilepticus which is associated with increased overall mortality in COVID-19 patients. Thus, as encephalopathy is often the only CNS symptom evidenced in patients with nonconvulsive seizures, more judicious use of continuous EEG in encephalopathic COVID-19 patients should be considered. This would facilitate earlier detection and treatment of seizures in this population, which would ultimately improve outcomes. Further research into the onset and potential for development of seizures and epilepsy in patients with COVID-19 is needed.

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Cerebrospinal fluid findings in patients with seizure in the setting of COVID-19: A review of the literature

Cited by 18 publications

References 80 publications

Ictogenesis of viral pneumonia: A comparison between SARS-CoV-2 and H1N1/H3N2

Ictogenesis of viral pneumonia: A comparison between SARS-CoV-2 and H1N1/H3N2

New-Onset Seizures in Patients With COVID-19: A Case Series From a Single Public Hospital in Korea

SARS-CoV-2 infection and seizures: the perfect storm

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