Intermittent Frontal Rhythmic Discharges as an Electroencephalogram Biomarker of Acute SARS-CoV-2 Infection-Associated Encephalopathy in Children

Khair, Abdulhafeez M

doi:10.7759/cureus.19149

Cited by 4 publications

(14 citation statements)

References 32 publications

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“…Studies based on the neurological manifestations of COVID-19 in the literature show that the frequency reaches 36% in adults, while a limited number of pediatric reports show variations between 4–28%, similar to our study. [ 6 – 26 ] Similar to the literature, major neurological manifestations among our patients were headache (n:17, 7%), anosmia/hyposmia (n:17, 7%) and seizure (n:4, 1.6%). However, unlike some studies, headache and hyposmia/anosmia were found with equal frequency in our study.…”

Section: Discussionsupporting

confidence: 86%

“…Unlike the literature, in our study, the number of boys (n:13, 37.1%) was slightly smaller than the number of girls (n:22, 62.9%) in Group 1. [6–26] Most studies have reported that there is no gender difference in terms of neurological findings among children. [6–26] However, 1 study reported that headache was more common in girls.…”

Section: Discussionmentioning

confidence: 99%

“…[6,[9][10][11][12]15,23,26,[53][54][55] Reports show that seizures are observed more frequently in patients with underlying neurological disease and/or hospitalised for severe illness. [6,[9][10][11][12]15,23,26,[53][54][55] Unlike the literature, in our study, the number of boys (n:13, 37.1%) was slightly smaller than the number of girls (n:22, 62.9%) in Group 1. Most studies have reported that there is no gender difference in terms of neurological findings among children.…”

Section: Discussionmentioning

confidence: 99%

“…Although data on the age of COVID-19-infected children with neurological findings are limited, reports show that these findings are more common in young children. [6–26] The literature also shows the occurrence of seizures in older children. [24,26,56,57] However, a study reported that the frequency of seizures increased in young children, occurring at a rate of 38% under the age of 5 years.…”

Section: Discussionmentioning

confidence: 99%

“…The frequency of seizures in children with COVID-19 varies between 0.7% and 52.9%. [6,[9][10][11][12]15,23,26,[53][54][55] Reports show that seizures are observed more frequently in patients with underlying neurological disease and/or hospitalised for severe illness. [6,[9][10][11][12]15,23,26,[53][54][55] Unlike the literature, in our study, the number of boys (n:13, 37.1%) was slightly smaller than the number of girls (n:22, 62.9%) in Group 1.…”

Section: Discussionmentioning

confidence: 99%

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Neurological symptoms and signs associated with COVID-19 in pediatric patients: a single-center experience

Okur¹

2022

Medicine

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There is insufficient evidence on SARS-CoV-2 induced neurological effects. Studies on CNS involvement during COVID-19 in children are limited. This study aims to identify and manage the neurological signs and symptoms in COVID-19-infected pediatric patients during follow up and plan future follow-ups.Children diagnosed COVID-19 and hospitalized in the pediatric pandemic services, between March 18, 2020, and June 18, 2021, were included in the study. Children with underlying neurological disease were excluded from the study. Patient data retrieved from hospital files and medical records. Children divided into 2 groups, 1 and 2, based on the presence or absence of neurological findings.A total of 243 children received follow-ups in the pandemic wards, 35 (14.4%) of these patients had neurological findings. Major neurological manifestations were headache (n:17, 7%), seizure (n:4, 1.6%), and anosmia/hyposmia (n:17, 7%). The number of boys (n:13, 37.1%) was smaller than the number of girls (n:22, 62.9%) in Group 1. Group 1 showed higher blood leukocyte, lymphocyte, thrombocyte, AST, LDH, d-dimer values. Anosmia/hyposmia occurred more often in girls, anosmia and headache occurred more often over 9 years of age. Pulmonary and hematologic involvement was more common in children with anosmia and headache.Our study is one of the few studies on neurological involvement in COVID-19 in children. To the best of our knowledge, there is limited data on these subjects in the literature. Abbrevations: AST = aspartate aminotransferase, CK = creatine kinase, CNS = central nervous system, COVID-19 = new type of coronavirus disease, CRP = C-reactive protein, CT = computed tomography, LDH = lactate dehydrogenase, NIMV = noninvasive mechanical ventilation, PICU = pediatric intensive care unit, PCR = polymerase chain reaction, SPSS = Statistical Package for the Social Sciences, WHO = world health organization.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Neurological symptoms and signs associated with COVID-19 in pediatric patients: a single-center experience

Okur¹

2022

Medicine

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Parallel electrophysiological abnormalities due to COVID‐19 infection and to Alzheimer's disease and related dementia

Jiang,

Neal,

Sompol

et al. 2024

Alzheimer's & Dementia

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Many coronavirus disease 2019 (COVID‐19) positive individuals exhibit abnormal electroencephalographic (EEG) activity reflecting “brain fog” and mild cognitive impairments even months after the acute phase of infection. Resting‐state EEG abnormalities include EEG slowing (reduced alpha rhythm; increased slow waves) and epileptiform activity. An expert panel conducted a systematic review to present compelling evidence that cognitive deficits due to COVID‐19 and to Alzheimer's disease and related dementia (ADRD) are driven by overlapping pathologies and neurophysiological abnormalities. EEG abnormalities seen in COVID‐19 patients resemble those observed in early stages of neurodegenerative diseases, particularly ADRD. It is proposed that similar EEG abnormalities in Long COVID and ADRD are due to parallel neuroinflammation, astrocyte reactivity, hypoxia, and neurovascular injury. These neurophysiological abnormalities underpinning cognitive decline in COVID‐19 can be detected by routine EEG exams. Future research will explore the value of EEG monitoring of COVID‐19 patients for predicting long‐term outcomes and monitoring efficacy of therapeutic interventions.Highlights Abnormal intrinsic electrophysiological brain activity, such as slowing of EEG, reduced alpha wave, and epileptiform are characteristic findings in COVID‐19 patients. EEG abnormalities have the potential as neural biomarkers to identify neurological complications at the early stage of the disease, to assist clinical assessment, and to assess cognitive decline risk in Long COVID patients. Similar slowing of intrinsic brain activity to that of COVID‐19 patients is typically seen in patients with mild cognitive impairments, ADRD. Evidence presented supports the idea that cognitive deficits in Long COVID and ADRD are driven by overlapping neurophysiological abnormalities resulting, at least in part, from neuroinflammatory mechanisms and astrocyte reactivity. Identifying common biological mechanisms in Long COVID‐19 and ADRD can highlight critical pathologies underlying brain disorders and cognitive decline. It elucidates research questions regarding cognitive EEG and mild cognitive impairment in Long COVID that have not yet been adequately investigated.

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Clinical manifestations and EEG findings in children infected with COVID-19 and exhibiting neurological symptoms

Yang,

Yu,

Yang

et al. 2024

BMC Pediatr

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Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection has many neurological manifestations, and its effects on the nervous system are increasingly recognized. There has been no systematic analysis of electroencephalography (EEG) characteristics in children exhibiting neurological symptoms of Coronavirus disease 2019 (COVID-19). The primary aim of this study was to describe the EEG characteristics caused by COVID-19 infection in children who were showing neurological symptoms and to assess the relationship between COVID-19-related EEG changes and clinical features in these children. Method: This study included 125 pediatric patients infected with SARS-CoV2 and showing neurological symptoms, and their continuous EEG was recorded. In addition, the demographic and clinical characteristics of these patients were analyzed and the correlation between the two was investigated. Results: Abnormal EEG findings were detected in 31.20% (N = 39) of the patients. Abnormal discharges (43.59%) were the most common EEG abnormalities, followed by background abnormalities (41.03%). The proportion of patients diagnosed with febrile seizure was higher in the normal EEG group than in the abnormal EEG group (P = 0.002), while the opposite was true for epilepsy and encephalitis/encephalopathy (P = 0.016 and P = 0.003, respectively). The independent associated factors of abnormal EEG were age and total length of stay (P < 0.001 and P = 0.003, respectively). Non-specific EEG abnormalities were found in COVID-19-related encephalitis/encephalopathy. Conclusion: Our study corroborated that a small group of pediatric patients infected by COVID-19 and showing neurological symptoms may exhibit abnormal EEG. This study could help improve the understanding of clinical and EEG characteristics in children with COVID-19 and inform triage policies in other hospitals during the COVID-19 pandemic.

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Intermittent Frontal Rhythmic Discharges as an Electroencephalogram Biomarker of Acute SARS-CoV-2 Infection-Associated Encephalopathy in Children

Cited by 4 publications

References 32 publications

Neurological symptoms and signs associated with COVID-19 in pediatric patients: a single-center experience

Neurological symptoms and signs associated with COVID-19 in pediatric patients: a single-center experience

Parallel electrophysiological abnormalities due to COVID‐19 infection and to Alzheimer's disease and related dementia

Clinical manifestations and EEG findings in children infected with COVID-19 and exhibiting neurological symptoms

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