Neurocysticercosis, Epilepsy, COVID-19 and a Novel Hypothesis: Cases Series and Systematic Review

ABSTRACT

Background: There have been many patients with neurological manifestations reported in medical literature following a COVID-19 infection. We conducted a literature review to identify patients with coronavirus disease (COVID-19) who presented with Neurocysticercosis (NCC) and associated seizure disorders/ epilepsy. Currently, there is a new variant of the COVID-19 virus strain invading South Africa and no indication when this pandemic will end and what kind of tardive sequelae may occur going forward. Case We searched the medical literature looking for all publications regarding NCC, Status Epilepticus (SE), Epileptic Seizures (ES), and Epilepsy (Ep), in patients infected by COVID-19. Based on the therapeutic response of our series, we propose a novel approach for patients presenting NCC, epilepsy and associated with COVID-19. We have hypothesized on the pathogenesis of ES and SE from the NCC/Cytokine Release Syndrome (CRS), SARS-CoV-2/CRS, including the role played by gut microbiota from the enteric nervous system (gut hormones, gut metabolites, inflammatory factors, neuroactive substances, and microbiota-derived products) to the medulla oblongata/hypothalamus-pituitary-adrenal axis via microbiota gut brain axis in ES, Ep and associated depression, plus the mechanism of hyperferritinemia on the overall process. This article is the first publication approaching this comorbidity as far as we know.