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

Neurol Sci. 2021 Feb;42(2):415-431. doi: 10.1007/s10072-020-04932-2. Epub 2020 Nov 25.

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: COVID-19; Coronavirus; EEG; Epilepsy; Seizure.

Publication types

  • Systematic Review

MeSH terms

  • COVID-19* / complications
  • COVID-19* / diagnosis
  • COVID-19* / physiopathology
  • Electroencephalography*
  • Epilepsy* / diagnosis
  • Epilepsy* / physiopathology
  • Humans
  • Seizures* / diagnosis
  • Seizures* / etiology
  • Seizures* / physiopathology