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

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COVID-19

COVID-19, de novo seizures, and epilepsy: a systematic review Ali A. Asadi-Pooya 1,2

&

Leila Simani 3 & Mina Shahisavandi 1 & Zohreh Barzegar 1

Received: 22 September 2020 / Accepted: 20 November 2020 # Fondazione Società Italiana di Neurologia 2020

Abstract 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. Keywords Coronavirus . COVID-19 . EEG . Epilepsy . Seizure

Introduction Since late 2019, the world has been experiencing a catastrophic pandemic of a new coronavirus disease (COVID-19) caused * Ali A. Asadi-Pooya [email protected] Leila Simani [email protected] Mina Shahisavandi [email protected] Zohreh Barzegar [email protected] 1

Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

2

Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA

3

Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

by SARS-CoV2.[1]. Previous outbreaks of coronaviruses consist of the severe acute respiratory syndrome (SARS) in 2002 and the Middle East respiratory syndrome (MERS) in 2012.[2] Coronaviruses primarily target the human respiratory system. However, they have also been associated with neurological manifestations (e.g., seizures, change in mental status, and encephalitis).[2, 3]. Neurotropic and neuroinvasive capabilities of coronaviruses have been