Fatal case of simply influenza A (H3N2)-associated encephalitis in immunocompetent patient.

Influenza virus-associated encephalopathy/encephalitis is a rare entity in adults that can lead to severe neurological sequelae and even death. The clinical presentation can be quite diverse. This absence of a typical presentation along with the difficulty detecting the virus in the cerebrospinal fluid represents a diagnostic challenge. We present the case of a 79-year-old male with sudden onset of decreased consciousness and signs of right hemisphere damage. The presence of influenza A (H3N2) virus in respiratory sample along with compatible findings in cranial magnetic resonance led to the diagnosis. The patient died without responding to treatment with antivirals and immunomodulators and the anatomopathological study did not detect infectious agent. Early diagnostic suspicion is essential to establish adequate treatment and improve the prognosis.

Longitudinal reduction of quality of life in patients with epilepsy and no seizure increase during the COVID-19 pandemic

Background and aims: In early 2020, the novel coronavirus disease (COVID-19) pandemic has impaired medical care of chronic neurological diseases, including epilepsy. The objective of this study is to evaluate the impact of the COVID-19 pandemic in the levels of anxiety, depression, somnolence and quality of life using validated scales in patients with epilepsy in real-life clinical practice. Methods: Self-administered scales of anxiety disorders (GAD-7), depression (NDDI-E), somnolence (Epworth Sleepiness Scale;ESS) and quality of life (QOLIE-31-P) in patients with epilepsy treated in the Refractory Epilepsy Unit of a tertiary hospital were longitudinally analyzed with Generalized Linear Mixed Models. Data were collected before the beginning (December 2019-March 2020) and during the COVID-19 pandemic (September 2020-January 2021). Results: 37 patients, 45.0±17.3 years of age, 43.2% women, epilepsy duration 23.0±14.9 years, number of anti-epileptic drugs 2.1±1.4, answered in the two periods. Significant longitudinal reduction of QOLIE-31-P scores (from 58.9±19.7 to 56.2±16.2, p=0.035) was identified. No statistically significant longitudinal changes in NDDI-E (from 12.3±4.3 to 13.4±4.4, p=0.293) or the number of seizures (from 0.9±1.9 to 2.5±6.2, p=0.125) were found. Significant higher ESS (from 4.9±3.7 to 7.4±4.9, p=0.001) and lower GAD-7 scores (from 8.8±6.2 to 8.3±5.9, corrected p=0.024 adjusted by refractory epilepsy and sleep disturbance) were found during the COVID-19 pandemic. Conclusion: During the COVID-19 pandemic, quality of life was lower in patients with epilepsy, levels of anxiety were reduced and sleepiness levels were raised, without seizure change. Additional studies would be useful to adequately manage these comorbidities.