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Observational Study
. 2021 Aug:174:106650.
doi: 10.1016/j.eplepsyres.2021.106650. Epub 2021 May 5.

Acute symptomatic seizures and COVID-19: Hospital-based study

Eman M Khedr  1 , Ahmed Shoyb  2 , Mahmoud Mohammaden  3 , Mostafa Saber  2
Affiliations
Observational Study

Acute symptomatic seizures and COVID-19: Hospital-based study

Eman M Khedr et al. Epilepsy Res. 2021 Aug.

Abstract

Background and purpose: Post COVID-19 seizures are relatively rare. The aim of the present study was to estimate the frequency of acute symptomatic seizures among patients with COVID-19 and to discuss possible pathophysiological mechanisms.

Material and methods: Out of 439 cases with COVID-19 that were admitted to Assiut and Aswan University hospitals during the period from 1 June to 10 August 2020, 19 patients (4.3 %) presented with acute symptomatic seizures. Each patient underwent computed tomography (CT) or magnetic resonance imaging (MRI) of the brain and conventional electroencephalography (EEG). Laboratory investigations included: blood gases, complete blood picture, serum D-Dimer, Ferritin, C-reactive protein, renal and liver functions, and coagulation profile.

Results: Of the 19 patients, 3 had new onset seizures without underlying pathology (0.68 % out of the total 439 patients); 2 others (0.46 %) had previously diagnosed controlled epilepsy with breakthrough seizures. The majority of cases (14 patients, 3.19 %) had primary pathology that could explain the occurrence of seizures: 5 suffered a post COVID-19 stroke (3 ischemic and 2 hemorrhagic stroke); 6 patients had COVID-related encephalitis; 2 patients were old ischemic stroke patients; 1 patient had a brain tumor and developed seizures post COVID-19.

Conclusion: acute symptomatic seizure is not a rare complication of post COVID-19 infection. Both new onset seizures and seizures secondary to primary brain insult (post COVID encephalitis or recent stroke) were observed.

Keywords: CNS; COVID-19; Cerebrovascular stroke; Encephalitis; Epilepsy; Seizure.

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Figures

Fig. 1
Fig. 1
The flowchart of all confirmed or probable COVID-19 patients (439) presented with seizures (19 patients).
See this image and copyright information in PMC

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