COVID-19 as a Cause of Acute Neonatal Encephalitis and Cerebral Cytotoxic Edema

Fragoso, Diego Cardoso; Marx, Catherine; Dutra, Bruna Garbugio; Silva, Carlos Jorge da; Silva, Pollyanna Martins da; Maia, Antônio Carlos Martins; Tobara, Mariana Crema; Silva, Camila de Almeida; Dias, Lívio; Polycarpo, Angela Cristina; Richtmann, Rosana

doi:10.1097/inf.0000000000003145

Cited by 23 publications

(22 citation statements)

References 11 publications

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“…One patient's EEG showed electrographic seizures, one patient's EEG showed excessive sharp waves, two of the patient's EEG showed generalized slowing, one patient's EEG showed frontal intermittent delta slowing, and one patient's EEG was normal. The most commonly used treatment was benzodiazepine and all the patients fully recovered [10][11][12][13][14][15]. Our review of literature looking for diagnosed epilepsy and association with COVID-19 infection in the pediatric population using PubMed [16,17] showed two patients with known epilepsy with worsening seizures in the setting of COVID-19 infection.…”

Section: Discussionmentioning

confidence: 97%

New-Onset Seizures as an Acute Presentation With Atypical EEG Findings in a Previously Healthy Child With Asymptomatic COVID-19 Infection

Akbar¹,

Ahmad²

2022

Cureus

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Coronavirus disease 2019 (COVID-19) infection is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This infection usually presents with upper respiratory symptoms; however, it can also present with a wide variety of other multisystem and neurological symptoms, including seizures. There are several proposed mechanisms by which COVID-19 can cause systemic signs of infections, including neurological complications and seizures.This case report describes a pediatric patient without a previously documented history of epilepsy who was admitted for new-onset focal seizures with impaired consciousness. No other cause and triggers of seizures were found, and the child was tested positive for COVID-19 infection. The patient had six electroclinical seizures during EEG. Video EEG findings showed atypical features of onset of intermittent rhythmic delta activity (IRDA) slowing over the left hemisphere with evolution/generalization of rhythmic delta/theta activity and without clear typical generalized epileptiform discharges. These EEG findings correlated with a clinical change of behavior arrest, staring, and yawning. Similar spells were reported multiple times a day prior to the admission, and past EEG was normal. A review of current literature on COVID-19 and neurological manifestations in children, including new seizures and prior diagnosis of epilepsy, is also provided in this case report.The clinical experience in children with newly diagnosed or chronic epilepsy suggests that exacerbation of seizures, especially from systemic effects such as those caused by severe COVID-19 infection, will be a major concern.

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Section: Discussionmentioning

confidence: 97%

New-Onset Seizures as an Acute Presentation With Atypical EEG Findings in a Previously Healthy Child With Asymptomatic COVID-19 Infection

Akbar¹,

Ahmad²

2022

Cureus

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“…Patients presenting with encephalopathy, especially the ones with severe COVID-19 or MIS-C had increased mortality and worse outcomes. In this regard, there have also been reports of children presenting with encephalopathy as a sign of acute, and sometimes fatal, cerebral edema associated with COVID-19 [ 19 , 41 , 66 , 67 ].…”

Section: Neurologic Manifestations Associated With Sars-cov-2 Infecti...mentioning

confidence: 99%

COVID-19 and neurologic manifestations: a synthesis from the child neurologist’s corner

Valderas¹,

Méndez²,

Echeverría³

et al. 2022

World J Pediatr

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“…Clinical presentations include fever, headache, conscious disturbance, seizure, and behavioral change. Numerous cases of COVID-19 associated encephalitis have been reported [ 9 , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] ]. Electron microscopic evidence of SARS-CoV-2 inclusions has been found in the cerebellum in a child with acute COVID-19 infection [ 9 ].…”

Section: Mr Neuroimagingmentioning

confidence: 99%

“…[ 10 ]. Numerous case reports have indicated the presence of acute encephalopathy or encephalitis [ [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] ], acute necrotizing encephalopathy (ANE) [ 25 , 26 ], acute disseminated encephalomyelitis (ADEM) [ 20 , [26] , [27] , [28] , [29] , [30] , [31] , [32] ], cytotoxic lesions in the callosal splenium [ 26 , [33] , [34] , [35] , [36] , [37] ], posterior reversible encephalopathy syndrome (PRES) [ 26 , 38 ], cerebral venous thrombosis [ 39 , 40 ], vasculitis and acute infarction [ 20 , 21 , [41] , [42] , [43] , [44] , [45] , [46] , [47] ], Guillain–Barré syndrome (GBS) [ 20 , 21 , 26 , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] ] and its variant Miller-Fisher syndrome (MFS) [ [59] , [60] , [61] , [62] ], transverse myelitis [ 9 , 50 ,…”

Section: Introductionmentioning

confidence: 99%