De Novo Status Epilepticus in patients with COVID-19

Abstract

Neurological complications are increasingly recognized with SARS-CoV-2, the causative pathogen for COVID-19. We present a single-center retrospective case series reporting the EEG and outcome of de novo status epilepticus (SE) in two African-American women with laboratory-confirmed SARS-CoV-2 virus. SE was the initial presentation in one asymptomatic individual. Patient 2 had COVID-19 pneumonia, and fluctuating mental status that raised the suspicion of subclinical SE. The patient with older age and higher comorbidities failed to recover from the viral illness that has no definitive treatment.

Figure 1

Scalp EEG in a bipolar montage from subject #1 demonstrating emergence of low amplitude ictal fast rhythmic activity over left fronto‐central and midline regions (marked with an arrow). Timebase 15 mm/sec, sensitivity 5 uV/mm, LFF 1 Hz, HFF 70 Hz.

Figure 2

Scalp EEG in a bipolar montage from subject #1 demonstrating the progression of the seizure (Fig. 1) and clinical accompaniment with bilateral tonic–clonic activity. Timebase 15 mm/sec, sensitivity 5 uV/mm, LFF 1 Hz, HFF 70 Hz.

Figure 3

Scalp EEG in a bipolar montage from subject #2 demonstrating independent periodic discharges over left (marked with double asterisks) and the right hemisphere (marked with an asterisk) and a focal seizure emanating from the right fronto‐central‐parietal region (marked with an arrow).Timebase 30mm/sec, sensitivity 5 uV/mm, LFF 1 Hz, HFF 70 Hz.

Figure 4

Scalp EEG in a bipolar montage from subject #2 demonstrating a focal seizure emanating from the left fronto‐central‐parietal region (marked with an arrow). Timebase 30mm/sec, sensitivity 5 uV/mm, LFF 1 Hz, HFF 70 Hz.