Systematic review of EEG findings in 617 patients diagnosed with COVID-19.
Systematic review of EEG findings in 617 patients diagnosed with COVID-19.
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DOI：
10.1016/j.seizure.2020.10.014
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发表时间：
2020-12
期刊：
影响因子：
--
通讯作者：
Haneef Z
中科院分区：
文献类型：
--
作者：
Antony AR;Haneef Z
我们对文献进行了系统的回顾，以综合新冠肺炎中关于脑电发现的数据。据报道，额部脑电模式是新冠肺炎脑病的特征性表现。尽管有几份脑电异常的报告，但典型的发现尚不清楚。用“COVID”或“冠状病毒”或“SARS”和“EEG”查询研究数据库。对84项研究中报告的617名患者的脑电结果进行了可用数据分析。中位年龄61.3岁(IQR45−69，女性33.3%)。常见的脑电指标是精神状态改变(61.7%)、癫痫样事件(31.2%)和心脏骤停(3.5%)。脑电异常543例(88.0%)：(1)背景异常：弥漫性减慢423例(68.6%)，局灶性减慢105例(17.0%)，后优势节律缺失63例(10.2%)。(2)周期节律脑电类型：全身性周期性放电35例(5.7%)，偏侧/多灶性周期性放电24例(3.9%)，全身性节律活动32例(5.2%)。(3)癫痫样改变：局灶性35例(5.7%)，全身性27例(4.4%)，癫痫发作/持续状态34例(5.5%)。额部脑电模式约占所有发现的三分之一。在使用连续脑电监测的研究中，96.8%的患者报告有异常，而没有接受连续脑电监测的患者中有85.0%(n=311)有异常(χ2=22.8p=0.001)。脑电异常在新冠肺炎相关脑病中很常见，并与疾病严重程度、先前存在的神经疾病(包括癫痫)和脑电监测时间过长有关。额部发现是常见的，已被建议作为新冠肺炎脑病的生物标志物。
We performed a systematic review of the literature to synthesize the data on EEG findings in COVID-19. Frontal EEG patterns are reported to be a characteristic finding in COVID-19 encephalopathy. Although several reports of EEG abnormalities are available, there is lack of clarity about typical findings. Research databases were queried with the terms “COVID” OR “coronavirus” OR “SARS” AND “EEG”. Available data was analyzed from 617 patients with EEG findings reported in 84 studies. The median age was 61.3 years (IQR 45−69, 33.3 % female). Common EEG indications were altered mental status (61.7 %), seizure-like events (31.2 %), and cardiac arrest (3.5 %). Abnormal EEG findings (n = 543, 88.0 %) were sub-classified into three groups: (1) Background abnormalities: diffuse slowing (n = 423, 68.6 %), focal slowing (n = 105, 17.0 %), and absent posterior dominant rhythm (n = 63, 10.2 %). (2) Periodic and rhythmic EEG patterns: generalized periodic discharges (n = 35, 5.7 %), lateralized/multifocal periodic discharges (n = 24, 3.9 %), generalized rhythmic activity (n = 32, 5.2 %). (3) Epileptiform changes: focal (n = 35, 5.7 %), generalized (n = 27, 4.4 %), seizures/status epilepticus (n = 34, 5.5 %). Frontal EEG patterns comprised of approximately a third of all findings. In studies that utilized continuous EEG, 96.8 % (n = 243) of the 251 patients were reported to have abnormalities compared to 85.0 % (n = 311) patients who did not undergo continuous EEG monitoring (χ2 = 22.8, p =< 0.001). EEG abnormalities are common in COVID-19 related encephalopathy and correlates with disease severity, preexisting neurological conditions including epilepsy and prolonged EEG monitoring. Frontal findings are frequent and have been proposed as a biomarker for COVID-19 encephalopathy.
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