COVID-19 and Epilepsy (preprint)

Introduction: COVID-19 caused by SARS-CoV-2 acquired via respiratory droplets. It can present with many systemic disorders, includingA 45-year-old Sudanese male known to have well-controlled generalized tonic-clonic epilepsy, He presented to the Accident and Emergency (A&E) department complaining of refractory status epilepticus. Despite immediate initial stabilization, the seizure attacks were still refractory to intravenous loading doses of antiepileptic drugs AEDs. Hence the patient was intubated and mechanically ventilated. Brain MRI and EEG were normal. The chest X-ray was normal. The screening of COVID-19 was positive.Epilepsy is one of the most common neurological disorders. Since the beginning of the Coronavirus outbreak in December 2019, no available research data is suggesting that the patients with epilepsy are at more risk than others. As no available data relating epilepsy to severe COVID-19 infection (6). Moreover, no data studied COVID-19 and the sudden unexpected death among epileptic patients (SUDEP).Conclusion: This case might report the effect of SARS-CoV-2 on provoking the refractory seizures in a previously well-controlled patient with epilepsy. More researches are needed to explain the relation between COVID and seizure threshold.

COVID-19 and Ischemic Stroke (preprint)

Background: SARS-CoV-2 causes COVID-19 disease. It was identified in December 2019 and rapidly evolved into a pandemic. During the outbreak of COVID-19, researches demonstrated its effect on many systems, including the nervous system. In our clinic, we have reported an impact of SARS-CoV-2, causing the ischaemic stroke.Case Report: A 62-year-old Sudanese male with some comorbidities brought to the A&E with fever, chest symptoms, and acute evolving left-sided hemiplegia power grade 0/5 MRCS with left upper motor neuron facial palsy. Investigations: CT brain: right middle cerebral artery MCA infarction. CT- chest: bilateral ground-glass appearance. COVID-19 Test was positive. elevated D-dimer and C-reactive protein.Discussion: A retrospective study of data from the COVID-19 outbreak in China showed that the incidence of stroke among hospitalized patients was approximately 5%. The fact that COVID-19 is an acute inflammatory condition associated with an increased incidence of fatty plaques formation, injury of the vascular wall, and hypercoagulability, causing brain infarct can be a reasonable hypothesis.ConclusionPatients with COVID-19 are at increased risk of thrombo-embolization, leading to arterial and venous cerebrovascular accident. This case report enhances the importance of further studies to clarify the relationship between stroke and COVID-19.