September 23, 2020

Continuous EEG Characteristics and Acute Symptomatic Seizures in COVID-19 Patients

Abstract, published in Clinical Neurophysiology

Objective: As concerns regarding neurological manifestations in COVID-19 patients increase, limited data exists on continuous electroencephalography (cEEG) findings in these patients. We present a retrospective cohort study of cEEG monitoring in COVID-19 patients to better explore this knowledge gap.

Methods: Among 22 COVID-19 patients, 19 underwent cEEGs, and 3 underwent routine EEGs, the latter of which last less than one hour. Demographic and clinical variables, including comorbid conditions, discharge disposition, survival and cEEG findings, were collected.

Results: cEEG was performed for evaluation of altered mental status (n = 17) or seizure-like events (n = 5). Five patients, including 2 with epilepsy, had epileptiform abnormalities on cEEG. Two patients had electrographic seizures without a prior epilepsy history. There were no acute neuroimaging findings. Periodic discharges were noted in one-third of patients and encephalopathic EEG findings were not associated with IV anesthetic use.

Conclusions & Significance: Interictal epileptiform abnormalities in the absence of prior epilepsy history were rare. However, the discovery of asymptomatic seizures in two of twenty-two patients was higher than previously reported and is therefore of concern. cEEG monitoring in COVID-19 patients may aid in better understanding an epileptogenic potential of SARS-CoV2 infection. Nevertheless, larger studies utilizing cEEG are required to better examine acute epileptic risk in COVID-19 patients.

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