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Systematic review of EEG findings in 617 patients diagnosed with COVID-19.
Antony, Arun Raj; Haneef, Zulfi.
  • Antony AR; 9100 Babcock Boulevard, Professional Building T, Pittsburgh, PA, 15237, United States.
  • Haneef Z; Department of Neurology, Baylor College of Medicine, Houston, TX, 77030, United States; Neurology Care Line, VA Houston Medical Center, Houston, TX, 77030, United States. Electronic address: zulfi.haneef@bcm.edu.
Seizure ; 83: 234-241, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-872486
ABSTRACT

OBJECTIVE:

We performed a systematic review of the literature to synthesize the data on EEG findings in COVID-19. Frontal EEG patterns are reported to be a characteristic finding in COVID-19 encephalopathy. Although several reports of EEG abnormalities are available, there is lack of clarity about typical findings.

METHODS:

Research databases were queried with the terms "COVID" OR "coronavirus" OR "SARS" AND "EEG". Available data was analyzed from 617 patients with EEG findings reported in 84 studies.

RESULTS:

The median age was 61.3 years (IQR 45-69, 33.3 % female). Common EEG indications were altered mental status (61.7 %), seizure-like events (31.2 %), and cardiac arrest (3.5 %). Abnormal EEG findings (n = 543, 88.0 %) were sub-classified into three groups (1) Background abnormalities diffuse slowing (n = 423, 68.6 %), focal slowing (n = 105, 17.0 %), and absent posterior dominant rhythm (n = 63, 10.2 %). (2) Periodic and rhythmic EEG patterns generalized periodic discharges (n = 35, 5.7 %), lateralized/multifocal periodic discharges (n = 24, 3.9 %), generalized rhythmic activity (n = 32, 5.2 %). (3) Epileptiform changes focal (n = 35, 5.7 %), generalized (n = 27, 4.4 %), seizures/status epilepticus (n = 34, 5.5 %). Frontal EEG patterns comprised of approximately a third of all findings. In studies that utilized continuous EEG, 96.8 % (n = 243) of the 251 patients were reported to have abnormalities compared to 85.0 % (n = 311) patients who did not undergo continuous EEG monitoring (χ2 = 22.8, p =< 0.001).

SIGNIFICANCE:

EEG abnormalities are common in COVID-19 related encephalopathy and correlates with disease severity, preexisting neurological conditions including epilepsy and prolonged EEG monitoring. Frontal findings are frequent and have been proposed as a biomarker for COVID-19 encephalopathy.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Electroencephalography / Epilepsy / COVID-19 Type of study: Diagnostic study / Experimental Studies / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Seizure Journal subject: Neurology Year: 2020 Document Type: Article Affiliation country: J.seizure.2020.10.014

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Electroencephalography / Epilepsy / COVID-19 Type of study: Diagnostic study / Experimental Studies / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Seizure Journal subject: Neurology Year: 2020 Document Type: Article Affiliation country: J.seizure.2020.10.014