Status epilepticus and other EEG findings in patients with COVID-19: A case series
Status epilepticus and other EEG findings in patients with COVID-19: A case series
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DOI：
10.1016/j.seizure.2020.08.022
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发表时间：
2020-10-01
影响因子：
3
通讯作者：
Falco-Walter, Jessica
中科院分区：
文献类型：
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作者：
Chen, Wendy;Toprani, Sheela;Falco-Walter, Jessica
目的：COVID-19感染的神经系统表现包括意识障碍、中风和癫痫发作。已经发表了有限的描述COVID-19患者EEG异常的报告。这些文章报告了非特异性脑病模式、癫痫样放电和罕见癫痫发作。我们的主要目的是评估COVID-19患者的EEG异常，并评估癫痫样活动或癫痫发作。方法：我们确定了5名接受EEG监测的COVID-19重症成年患者。结果：5例患者均出现脑病，3例同时出现类似癫痫样运动，提示脑电图监测。脑电图均显示非特异性脑病标志物，包括弥漫性减慢和全身节律性δ活动。2例患者的癫痫样放电有时达到2-3 Hz，1例患者处于非惊厥性癫痫持续状态，另1例患者发展为临床癫痫持续状态伴肌阵挛运动。EEG和临床症状改善与抗癫痫药物。结论：癫痫持续状态存在于我们的队列中的5例重症患者进行EEG监测。这些发现强调了脑电图监测在高风险COVID-19和脑病患者中的重要性。脑电图记录在这样的患者可以识别病理模式，将受益于治疗与抗癫痫药物。
Purpose: Neurological manifestations of COVID-19 infection include impaired consciousness, strokes, and seizures. Limited reports describing EEG abnormalities in patients with COVID-19 have been published. These articles reported nonspecific encephalopathic patterns, epileptiform discharges, and rarely seizures. Our primary aim was to assess EEG abnormalities in patients with COVID-19 and evaluate for epileptiform activity or seizures.Methods: We identified five critically ill adult patients with COVID-19 who underwent EEG monitoring. All patients had Ceribell (TM) rapid response EEG initially and two continued with conventional long-term video EEG.Results: All 5 patients had encephalopathy and 3 also had seizure-like movements, thus prompting EEG monitoring. EEGs all showed nonspecific markers of encephalopathy including diffuse slowing and generalized rhythmic delta activity. Two also had epileptiform discharges reaching 2-3 Hz at times, with one patient in nonconvulsive status epilepticus and the other developing clinical status epilepticus with myoclonic movements. EEG and clinical symptoms improved with anti-seizure medications.Conclusion: Status epilepticus was present in 2 out of our cohort of 5 critically ill patients who underwent EEG monitoring. These findings highlight the importance of EEG monitoring in high-risk patients with COVID-19 and encephalopathy. EEG recordings in such patients can identify pathological patterns that will benefit from treatment with anti-seizure medications.