Post-covid Epilepsy: A Review of Epilepsy Monitoring Unit Admissions During the Two Years of COVID-19 Pandemic
Abstract number :
2.112
Submission category :
4. Clinical Epilepsy / 4B. Clinical Diagnosis
Year :
2022
Submission ID :
2204138
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:23 AM
Authors :
Eric Dunn, DO – Cleveland Clinic; Faisal Ibrahim, MD – Cleveland Clinic; Silvia Neme-Mercante, MD – Cleveland Clinic; Dileep Nair, MD – Cleveland Clinic; Spencer Morris, MS – Cleveland Clinic; Irene Wang, PhD – Cleveland Clinic; Imad Najm, MD – Cleveland Clinic; Vineet Punia, MD – Cleveland Clinic
Rationale: With the emerging long-term neurological manifestations of coronavirus disease 2019 (COVID-19), we analyzed diagnostic epilepsy monitoring unit (EMU) evaluations in post-COVID patients to investigate the possibility of epilepsy development as a sequela of COVID-19 infection.
Methods: We thoroughly reviewed our EMU database and identified patients having “COVID” or “Corona” virus mention in their medical record from March 15, 2020, to February 28, 2022. Patients with an epilepsy diagnosis prior to COVID-19 infection were excluded.
Results: Among 62 patients without a prior history of epilepsy evaluated in the EMU for new-onset spells after confirmed COVID-19 infection, three patients (4.8%) were diagnosed with focal epilepsy. These three women without epilepsy risk factors had seizure onset at the time of, or within 1 to 3 months of, COVID-19 diagnosis. Their 3T MRI imaging was non-lesional but revealed bilateral enlarged perivascular spaces. Video EEG monitoring was consistent with temporal or fronto-temporal lobe epilepsy in all three patients. Two of the patients developed drug-resistant epilepsy within 6-months of seizure onset.
Conclusions: There have been previous reports of seizures developing in the setting of acute COVID-19 infection, but there has been only one other report to date of a patient developing temporal lobe epilespy approximately six-weeks after COVID-19 infection requiring hospitalization.1 Our thorough analysis of diagnostic EMU evaluations during the two years of the pandemic reveals three cases of post-COVID-19 epilepsy after asymptomatic to mild infection. All three patients presented here were diagnosed with new-onset temporal lobe epilepsy, which could be related to changes in limbic structures following COVID-infection.2 Although coincidental epilepsy onset cannot be ruled out, larger multicenter or national database investigations are needed to further analyze the possibility of post-COVID epilepsy.
References:
1. Park S, Majoka H, Sheikh A, Ali I. A presumed case of new-onset focal seizures as a delayed complication of COVID-19 infection. Epilepsy Behav Rep. 2021;16:100447.
2. Douaud G, Lee S, Alfaro-Almagro F, et al. SARS-CoV-2 is associated with changes in brain structure in UK Biobank. Nature. 2022;604(7907):697-707.
Funding: No funding was received in support of this abstract.
Clinical Epilepsy