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Review
. 2020 Sep;61(9):1840-1853.
doi: 10.1111/epi.16656. Epub 2020 Sep 17.

COVID-19 and seizures: Is there a link?

Divya Vohora  1 , Shreshta Jain  1 , Manjari Tripathi  2 , Heidrun Potschka  3
Affiliations
Review

COVID-19 and seizures: Is there a link?

Divya Vohora et al. Epilepsia. 2020 Sep.

Abstract

The rapid spread of the SARS-CoV-2 pandemic poses particular challenges to the management of persons with chronic disease. Reports of a possible neuroinvasiveness of SARS-CoV-2 as well as pathophysiological mechanisms and indirect consequences in severe COVID-19 cases raise the question of whether the infection can be associated with an increased risk of seizure recurrence or the development of new onset and acute symptomatic seizures. Although the literature does not provide relevant evidence for seizure worsening in persons with epilepsy during the course of a SARS-CoV-2 infection, there are theoretical risks, for example, seizures triggered by fever. Moreover, a severe disease course and advanced disease stages can, for instance, result in hypoxic encephalopathy, cerebrovascular events, and cytokine storm, which may trigger the development of acute seizures. This is further confirmed by reports of occasional seizures in COVID-19 patients. Although the low number of reports so far suggests that the risk may be relatively low, the reports indicate that an early neurological manifestation with seizures should not be ruled out. In the context of these cases, we discuss possible pathophysiological mechanisms that may trigger ictogenesis in patients with SARS-CoV-2 infection.

Keywords: CNS; COVID-19; SARS-CoV-2; seizures.

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Conflict of interest statement

None of the authors has any conflict of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Percentage of articles published during the period January 1, 2020 through April 30, 2020 reporting the respective neurological symptoms in patients with SARS‐CoV‐2. The publications considered comprise original and review articles, including clinical observational studies, case reports, and/or case series, and were identified after an extensive database search in PubMed/MEDLINE and other databases including ScienceDirect, Semantic Scholar, and Google Scholar. The search string included “SARS‐CoV‐2” OR “COVID‐19” AND “epilepsy” OR “seizures” OR “central nervous system” OR “brain” OR “neurological findings” OR “cerebrovascular disease” OR “CNS infection” OR “neurological disorder”
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