Evaluation of Patients Presenting to the Pediatric Emergency Department with Seizures during the COVID-19 Pandemic

ABSTRACT

The coronavirus disease 2019 pandemic has led to significant changes in hospital visits worldwide. The admission rates have remarkably decreased. This study investigates the characteristics of 104 patients (54 girls, 50 boys) who presented to our pediatric emergency department (ED) with seizures during the pandemic between May 2020 and May 2021. Regarding seizure type, 84 generalized and 20 focal seizures had occurred. Tonic, tonic-clonic, clonic, and hypomotor seizures were seen in descending order. Thirty-seven patients were diagnosed with epilepsy, and 32 patients with first afebrile, 25 first febrile, and 10 recurrent febrile seizures. No patients had acute symptomatic seizures. In 85 patients, the seizures had stopped before the ED visit;only one lasted >60 minutes. Benzodiazepines were administered as a first-line drug. Demographical features, electroencephalogram (EEG), and cranial imaging findings, laboratory test results, and distribution by month and by the hour of ED visit were analyzed. Study data was in accordance with the literature by seizure types, seizure management, and cranial imaging rates but differed by distribution in terms of month and the hour of ED visit. The EEG abnormality rate was higher among the first afebrile seizure cases. The number of patients with seizures was 69, that is, 0.3% of emergency admissions, for the 4 months of 2019 before the pandemic, and 104, that is, 0.4% of emergency admissions for the whole initial year of the pandemic thereafter. So, the number of patients with seizures had decreased, but their rate had increased, which could be attributed to a decrease in the number of nonurgent presentations to the ED during the pandemic.