Seizures Related to Coronavirus Disease (COVID-19): Case Series and Literature Review

Ashraf, Muddasir; Sajed, Sulaiman

doi:10.7759/cureus.9378

Cited by 14 publications

(13 citation statements)

References 12 publications

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“…Seizure can also occur secondary to a meningitis/encephalitis associated with SARS-CoV-2 infection [ 7 ]. Furthermore, seizures can be the initial presentation of COVID-19 and patients may have no respiratory symptoms at all [ 81 ]. Apart from generalized tonic–clonic seizures, focal seizures have also been observed as a clinical feature of COVID-19 [ 82 ].…”

Section: Resultsmentioning

confidence: 99%

Neurological symptoms, manifestations, and complications associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 19 (COVID-19)

2021

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus, is responsible for the outbreak of coronavirus disease 19 (COVID-19) and was first identified in Wuhan, China in December 2019. It is evident that the COVID-19 pandemic has become a challenging world issue. Although most COVID-19 patients primarily develop respiratory symptoms, an increasing number of neurological symptoms and manifestations associated with COVID-19 have been observed. In this narrative review, we elaborate on proposed neurotropic mechanisms and various neurological symptoms, manifestations, and complications of COVID-19 reported in the present literature. For this purpose, a review of all current published literature (studies, case reports, case series, reviews, editorials, and other articles) was conducted and neurological sequelae of COVID-19 were summarized. Essential and common neurological symptoms including gustatory and olfactory dysfunctions, myalgia, headache, altered mental status, confusion, delirium, and dizziness are presented separately in sections. Moreover, neurological manifestations and complications that are of great concern such as stroke, cerebral (sinus) venous thrombosis, seizures, meningoencephalitis, Guillain–Barré syndrome, Miller Fisher syndrome, acute myelitis, and posterior reversible encephalopathy syndrome (PRES) are also addressed systematically. Future studies that examine the impact of neurological symptoms and manifestations on the course of the disease are needed to further clarify and assess the link between neurological complications and the clinical outcome of patients with COVID-19. To limit long-term consequences, it is crucial that healthcare professionals can early detect possible neurological symptoms and are well versed in the increasingly common neurological manifestations and complications of COVID-19.

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Section: Resultsmentioning

confidence: 99%

Neurological symptoms, manifestations, and complications associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 19 (COVID-19)

2021

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“…In the specific context of the direct viral action on the central nervous system, resulting in neurological symptoms, even though the majority of the analyzed cases did not present with RT-PCR positivity in cerebrospinal fluid 7,10,11,12,13,14,15,16 (either because of no availability of testing at the time, or low sensitivity -in one case, when repeated, results came out positive 17 ), two main pathways might be theorized: the targeting of the angiotensin-converting-enzyme-2 receptors, which are heavily present in the central nervous system, including brain cells, glial cells, and endothelial cells of the blood-brain barrier; or through the olfactory nerve, causing inflammation and demyelination 1,18,19 .…”

Section: Discussionmentioning

confidence: 99%

Electroencephalographic findings among inpatients with COVID-19 in a tertiary hospital from a middle-income country

Corazza

Tatsch

Barros

et al. 2021

Arq. Neuro-Psiquiatr.

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Background: In 2019, the world witnessed the emergence of a new type of coronavirus - the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The spectrum of coronavirus disease 2019 (COVID-19) is variable, and amongst its manifestations are neurological implications. Objective: This report aimed to describe electroencephalographic findings in COVID-19 patients from a general tertiary hospital in São Paulo, Brazil. Methods: It was a retrospective, observational, and non-interventional study. Data were collected anonymously, comprising inpatients from Mar 1 to Jun 30, 2020, either confirmed (positive RT-PCR) or probable cases (CO-RADS 4/5) who had performed EEG during hospitalization. Results: Twenty-eight patients were enrolled, 17 (60.7%) women and 11 men, with a median age of 58 (minimum and maximum: 18-86; IQR 23.5). COVID-19 diagnosis was confirmed in 22 (78.5%). Twenty-one patients (75%) had severe disease, requiring mechanical ventilation due to acute respiratory distress syndrome (ARDS); 16 (57.1%) patients developed adjunct sepsis throughout hospitalization. There was no specific pattern found for COVID-19 in EEG. No patients presented with status epilepticus or electrographic events; most patients developed an encephalopathic pattern, as seen in most studies, with a high prevalence of altered mental status as an indication for EEG. Adjunct sepsis was associated with higher mortality. Conclusions: EEG presents as a useful tool in the context of COVID-19, as in other conditions, to differentiate nonconvulsive status epilepticus (NCSE) from encephalopathy and other causes of mental status alterations. Further studies are required to analyze whether there might be a specific EEG pattern to the disease.

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“…Infection with SARS-CoV-2 reduces the seizures threshold which can worsen the case in epileptic patients or it can lead to seizures in patients with no history of seizures [ 137 , 138 , 139 , 140 ]. It is of note that seizures could be one of the initial symptoms in COVID-19 patients [ 141 ]. Focal seizures have been described in COVID-19 patients in addition to generalized tonic-clonic seizures [ 134 ].…”

Section: Neurological Disorders and Their Management In Covid-19 Patientsmentioning

confidence: 99%

Neurological Complications of COVID-19: Underlying Mechanisms and Management

Shehata

Lord

Grudzinski

et al. 2021

IJMS

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COVID-19 is a severe respiratory disease caused by the newly identified human coronavirus (HCoV) Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). The virus was discovered in December 2019, and in March 2020, the disease was declared a global pandemic by the World Health Organization (WHO) due to a high number of cases. Although SARS-CoV-2 primarily affects the respiratory system, several studies have reported neurological complications in COVID-19 patients. Headache, dizziness, loss of taste and smell, encephalitis, encephalopathy, and cerebrovascular diseases are the most common neurological complications that are associated with COVID-19. In addition, seizures, neuromuscular junctions’ disorders, and Guillain–Barré syndrome were reported as complications of COVID-19, as well as neurodegenerative and demyelinating disorders. However, the management of these conditions remains a challenge. In this review, we discuss the prevalence, pathogenesis, and mechanisms of these neurological sequelae that are secondary to SARS-CoV-2 infection. We aim to update neurologists and healthcare workers on the possible neurological complications associated with COVID-19 and the management of these disease conditions.

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Seizures Related to Coronavirus Disease (COVID-19): Case Series and Literature Review

Cited by 14 publications

References 12 publications

Neurological symptoms, manifestations, and complications associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 19 (COVID-19)

Neurological symptoms, manifestations, and complications associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 19 (COVID-19)

Electroencephalographic findings among inpatients with COVID-19 in a tertiary hospital from a middle-income country

Neurological Complications of COVID-19: Underlying Mechanisms and Management

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