Seizure in patients with COVID-19
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COVID-19
Seizure in patients with COVID-19 Amir Emami 1 & Nima Fadakar 2 & Ali Akbari 3 & Mehrzad Lotfi 4 & Mohsen Farazdaghi 2 & Fatemeh Javanmardi 1 & Tahereh Rezaei 5 & Ali A. Asadi-Pooya 2,6 Received: 29 June 2020 / Accepted: 15 September 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Objective The purpose of the current study was to collect the data on the occurrence of seizures in patients with COVID-19 and to clarify the circumstances of the occurrence of seizures in these patients. Methods All consecutive patients who referred to healthcare facilities anywhere in Fars province (located in South Iran with a population of 4.851 million people) from February 19 until June 2, 2020, and had confirmed COVID-19 by positive result on polymerase chain reaction testing and seizure were included. Results During the study period, 6,147 people had confirmed COVID-19 in Fars province, Iran; 110 people died from the illness (case fatality rate 1.79%). During this time period, five people had seizures (seizure rate 0.08%). In four patients, seizure was one of the presenting manifestations, and in one person, it happened during the course of hospital admission. Two patients had status epilepticus. All patients experienced hypoxemia and four of them needed respirator. Two patients had related metabolic derangements and one had cerebrospinal fluid (CSF) lymphocytic pleocytosis. Brain imaging was abnormal in three patients. Four patients died. Conclusion New-onset seizures in critically ill patients with COVID-19 should be considered as acute symptomatic seizures and the treating physician should try to determine the etiology of the seizure and manage the cause immediately and appropriately. Detailed clinical, neurological, imaging, and electrophysiological investigations and attempts to isolate SARS-CoV-2 from CSF may clarify the role played by this virus in causing seizures in these patients. Keywords Coronavirus . COVID . Epilepsy . Seizure
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10072-020-04731-9) contains supplementary material, which is available to authorized users. * Ali A. Asadi-Pooya [email protected]
Tahereh Rezaei [email protected]
Amir Emami [email protected]
1
Burn & Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Nima Fadakar [email protected]
2
Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Ali Akbari [email protected]
3
Department of Anesthesiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Mehrzad Lotfi [email protected]
4
Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Mohsen Farazdaghi [email protected]
5
Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Fatemeh Javanmardi [email protected]
6
Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia,
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