EEG findings in COVID-19 related encephalopathy

Pasini, Elena; Bisulli, Francesca; Volpi, L.; Minardi, Irene; Tappatà, Maria; Muccioli, Lorenzo; Pensato, Umberto; Riguzzi, P.; Tinuper, Paolo; Michelucci, Roberto

doi:10.1016/j.clinph.2020.07.003

Cited by 36 publications

(50 citation statements)

References 4 publications

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“…The full-text screening of these studies led to the exclusion of 216 studies that did not meet the inclusion criteria. A total of 12 studies with 308 patients fulfilled the eligibility criteria for inclusion in the meta-analysis [6] , [7] , [8] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] . We referred to a case report [26] of patients who were included in a case series [19] to obtain more detailed EEG findings.…”

Section: Resultsmentioning

confidence: 99%

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Meta-analysis of EEG findings in patients with COVID-19

Kubota

Gajera

Kuroda

2021

Epilepsy & Behavior

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Section: Resultsmentioning

confidence: 99%

“…Some studies successfully described EEG findings in patients with COVID-19 [6] , [7] , [8] . However, the number of patients in previous studies has been limited, and the proportions of abnormal findings in EEG vary across studies.…”

Section: Introductionmentioning

confidence: 99%

Meta-analysis of EEG findings in patients with COVID-19

Kubota

Gajera

Kuroda

2021

Epilepsy & Behavior

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“…However, some of the patients had specific neurological problems (e.g., encephalitis [33,40,70] and cerebrovascular events [38,42,43,51,59]). SARS-CoV-2 RNA was detected in the cerebrospinal fluid (CSF) in two patients [40,53]; however, many other studies that tested for this had negative results [36,42,44,46,52,59,60,64,67,70]. It should be emphasized that many centers did not investigate the patients with COVID-19, who had seizures, thoroughly.…”

Section: Resultsmentioning

confidence: 99%

COVID-19, de novo seizures, and epilepsy: a systematic review

et al. 2020

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Objective We discuss the evidence on the occurrence of de novo seizures in patients with COVID-19, the consequences of this catastrophic disease in people with epilepsy (PWE), and the electroencephalographic (EEG) findings in patients with COVID-19. Methods This systematic review was prepared according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. MEDLINE, Scopus, and Embase from inception to August 15, 2020 were systematically searched. These key words were used: "COVID" AND "seizure" OR "epilepsy" OR "EEG" OR "status epilepticus" OR "electroencephalography". Results We could identify 62 related manuscripts. Many studies were case reports or case series of patients with COVID-19 and seizures. PWE showed more psychological distress than healthy controls. Many cases with new-onset focal seizures, serial seizures, and status epilepticus have been reported in the literature. EEG studies have been significantly ignored and underused globally. Conclusion Many PWE perceived significant disruption in the quality of care to them, and some people reported increase in their seizure frequency since the onset of the pandemic. Telemedicine is a helpful technology that may improve access to the needed care for PWE in these difficult times. De novo seizures may occur in people with COVID-19 and they may happen in a variety of forms. In addition to prolonged EEG monitoring, performing a through metabolic investigation, electrocardiogram, brain imaging, and a careful review of all medications are necessary steps. The susceptibility of PWE to contracting COVID-19 should be investigated further.

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“…Brain MRI revealed non-specific white matter hyperintensities, ruling out structural lesions which could justify neurological manifestations. The altered mental status might have been caused also by non-convulsive status epilepticus, a clinical condition already associated with COVID-19 (Le Guennec et al, 2020), yet was excluded by the EEG, which showed diffuse slowing with frontal sharp waves, a finding frequently reported in COVID-19-related encephalopathy (Galanopoulou et al, 2020;Pasini et al, 2020). Aphasia was accompanied by manifestations consistent with dysexecutive syndrome and behavioral symptoms, suggesting a frontal lobe dysfunction.…”

Section: Discussionmentioning

confidence: 88%

COVID-19-related encephalopathy presenting with aphasia resolving following tocilizumab treatment

Muccioli

Pensato

Cani

et al. 2020

Journal of Neuroimmunology

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Encephalopathy is emerging as a recurrent complication of COVID-19 yet remains poorly characterized. We report the case of a middle-aged woman with COVID-19-related encephalopathy presenting as expressive aphasia and inattentiveness, subsequently progressing to agitation and marked confusion. Brain MRI and CSF analysis were unremarkable, while EEG showed slowing with frontal sharp waves. Neuropsychiatric symptoms resolved following treatment with tocilizumab. CNS involvement in COVID-19 may present as a subacute encephalopathy characterized by prominent frontal lobe dysfunction, with language disturbances as first neurological manifestation. Future studies should further investigate the role of tocilizumab in treating COVID-19-related encephalopathy.

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EEG findings in COVID-19 related encephalopathy

Cited by 36 publications

References 4 publications

Meta-analysis of EEG findings in patients with COVID-19

Meta-analysis of EEG findings in patients with COVID-19

COVID-19, de novo seizures, and epilepsy: a systematic review

COVID-19-related encephalopathy presenting with aphasia resolving following tocilizumab treatment

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