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Tonic clonic seizures following off label use: case report A 68-year-old woman developed tonic clonic seizures following off label use of hydroxychloroquine for coronavirus disease (COVID-19) pneumonia. Additionally, she received off label treatment with favipiravir and oseltamivir for COVID-19 pneumonia [dosages and routes not stated]. The woman was admitted to the emergency department with complaints of cough and fatigue and diagnosed with COVID-19 pneumonia. On admission, she received nasal oxygen therapy and administered with hydroxychloroquine and oseltamivir. On the second day, she was shifted to the ICU due to respiratory distress and oxygen desaturation. Favipiravir was then added to the treatment in the ICU. On the second day in the ICU, she developed a tonic clonic convulsion starting from her left arm and spreading to the whole body secondary to hydroxychloroquine therapy [duration of treatment to reaction onset not stated]. The woman received treatment with midazolam and treated successfully. Levetiracetam was also added to the treatment as anticonvulsant. On further investigations, she was diagnosed with underlying conditions of Fahr’s syndrome and hypoparathyroidism. On the next day, she was tracheally intubated and ventilated mechanically due to severe acute respiratory distress syndrome (ARDS). Midazolam and fentanyl were added for sedation. The ARDS secondary to COVID-19 pneumonia became severe. Unfortunately, she died on the 8th day in the ICU. Demir G, et al. Fahr’s syndrome presenting with seizures in SARS-CoV-2 (COVID-19) pneumonia-a case report. Neurological Sciences : Jan 2020. Available from: URL: 803508148 http://doi.org/10.1007/s10072-020-04733-7

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Reactions 17 Oct 2020 No. 1826