Epileptic seizures in patients with COVID-19: A systematic review of early evidences

B. Roy, I. Banerjee
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Abstract

Background: Global emergence of SARS-CoV-2 surfaced neurological complications amongst the patients. COVID-19 resembles with other coronavirus strains follows a trend of neurological complication, damage and encephalopathy, which entails considerable risks, requires attention for the neurologists. This is, to our knowledge, the first systematic review of the literature to investigate solely to elucidate the seizure spectrum by unfolding epileptogenicity of the SARS CoV-2 and potential pathways of neuroinvasion. Methods: A systematic literature search was performed in PubMed and Embase database following standard guidelines, using specific keywords based on epileptic seizure onset described from December 01, 2019, to July 17, 2020 Results: A total of 17 studies were included ranging from case reports, series of cases, multicentre cross-sectional study with the first-time onset of seizure associated with an epileptic origin. We excavated causes of complex COVID-19 related neurological manifestations, e.g., cerebrovascular diseases, encephalitis, demyelinating lesions, cytokine storm and proposed routes of SARS-CoV-2 entry into the nervous system to understand the mechanism of an epileptic seizure. Conclusion: COVID-19 is a potent neuropathogen which causes the new onset of epileptic seizures should get diagnostic recognition to evade possible deterioration of neurological conditions. However, more shreds of evidence from the future will further elucidate the epileptogenic potential of the pandemic.
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COVID-19患者癫痫发作:早期证据的系统回顾
背景:全球SARS-CoV-2的出现使患者出现神经系统并发症。COVID-19与其他冠状病毒毒株相似,具有神经系统并发症、损伤和脑病的趋势,具有相当大的风险,需要引起神经科医生的注意。据我们所知,这是首次对文献进行系统回顾,仅通过揭示SARS CoV-2的癫痫致痫性和神经侵袭的潜在途径来研究阐明癫痫谱。方法:根据2019年12月1日至2020年7月17日描述的癫痫发作的特定关键词,按照标准指南在PubMed和Embase数据库中进行系统的文献检索。结果:共纳入17项研究,包括病例报告、系列病例、多中心横断研究,首次发作与癫痫起源相关。挖掘脑血管病、脑炎、脱髓鞘病变、细胞因子风暴等与COVID-19相关的复杂神经系统表现的病因,提出SARS-CoV-2进入神经系统的途径,了解癫痫发作的机制。结论:COVID-19是一种强有力的神经病原体,可引起癫痫新发发作,应得到诊断识别,以避免可能的神经系统疾病恶化。然而,来自未来的更多证据碎片将进一步阐明大流行的致癫痫潜力。
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