Epileptic seizure and electroencephalographic characteristics of adult COVID-19 inpatients during the Omicron outbreak in China: a single center retrospective study (preprint)

Background This retrospective analysis assessed the characteristics of epileptic seizure and continuous electroencephalogram (CEEG) data in hospitalized patients diagnosed with COVID-19 during the Omicron outbreak.Methods CEEG was performed in 28 patients, with 17 showing unexplained altered mental status and 11 suspected of having seizures. Demographic and clinical variables, imaging results, outcomes, and comorbidities were collected.Results In total, 1,405 patients with COVID-19 infection were admitted during the study period. The proportion of patients who required intensive care unit (ICU) care and the in-hospital mortality was 16.3% and 7.8%, respectively. Among patients who underwent CEEG monitoring, 11 were in ICU, and 17 were in regular wards. Of these, 8 patients (28.5%) had severe COVID-19, whereas 6 had acute neuroimaging findings. EEG findings were not specific, with 7 patients (25%) having normal EEG results. Furthermore, 11 (39.3%) had benign EEG alterations, 6 (21.4%) had malignant, and 4 (14.3%) had highly malignant. Six patients exhibited epileptiform abnormalities, including 1 with a prior epilepsy history. Moreover, 4 patients experienced electrographic seizures, with 2 manifesting as epilepsia partialis continua and 2 as nonconvulsive status epilepticus. Periodic and rhythmic patterns were observed in 2 patients, spike-and-wave in 1 patient and generalized rhythmic delta activity in another patient. EEG attenuation without reactivity was seen in 4 patients.Conclusions Seizures can manifest as early symptoms in individuals infected with the Omicron variant of COVID-19. Despite the increased contagiousness associated with Omicron, we observed a higher prevalence of normal EEG results. This suggested that the Omicron variant may be associated with a lower likelihood of causing encephalitis or encephalopathy compared to other variants.

Epilepsia partialis continua due to COVID-19 pneumonia.

BACKGROUND: Epilepsia partialis continua (EPC) is an uncommon condition with several different etiological causes. In this article, we presented a case of EPC due to COVID-19 infection. CASE REPORT: A 77-year-old woman with diabetes, asthma, hypertension, and chronic renal failure went to the emergency room with shortness of breath. The patient was awake and had slight hemiparesis sequela on the left due to a cerebrovascular incident 20 years earlier on neurological assessment. Non-contrast thorax computed CT revealed patchy ground-glass alveolo-acinar density increases in bilateral lung subzones, confirming COVID-19 pneumonia. After getting a positive COVID-19 PCR test, the patient was admitted to the department of infectious diseases. After a week in the hospital, seizures involving the right arm, leg, and part of the face appeared. The patient could not respond to questions. The patient's seizures lasted 12-24 hours. EEG was compatible with Epilepsia partialis continua. The cerebrospinal fluid examination was normal. Both clinical and EEG findings of the patient improved with treatment. CONCLUSIONS: Several causes may contribute to the onset of Epilepsia partialis continua. COVID-19 infection might be one of the etiological explanations for the diagnosis of Epilepsia partialis continua and the prognosis may be very good too.