Abstract
Viral infection with SARS-CoV-2 has a neurological tropism that may induce an encephalopathy. In this context, electroencephalographic exploration (EEG) is indicated as a diagnostic argument correlated with lumbar puncture, biology, and imaging. We performed a retrospective analysis of 42 patients explored by EEG and infected by COVID-19, according to the EEG abnormalities and clinical signs that motivated the examination. Confusion and epileptic seizures were the most common clinical indications, with 64% of the patients displaying these symptoms. The EEG was altered in 85% of the cases of confusion, in 57% of the cases of epileptic symptoms (general or focal seizure or prolonged loss of contact) and 20% of the cases of malaise or brief loss of consciousness. Nine EEG (21%) were in favor of an encephalopathy, two had de novo alterations in persistent consciousness and two had alterations in general states of confusion; one was very agitated and without history of epilepsy and combined eyelids clonia while a second one exhibited unconsciousness with left hemicorpus clonus. Two were being investigated for delayed awakening without sedation for more than 24 h. All of these patients were diagnosed COVID-19, some of them with associated mild to severe respiratory disorders. This work shows the interest of the EEG in exploring COVID-19 patients suffering from neurological or general symptoms looking for cerebral alteration.
Highlights
The current pandemic viral infection with coronavirus 2 (SARS-CoV-2) appears to have, as its initial target, the respiratory tract inducing acute respiratory distress syndrome, in elderly subjects with certain risk factors including diabetes, immunosuppression, and chronic renal and respiratory failure
Twelve electroencephalographic exploration (EEG) were normal (21.8%), 9 showed a slight deceleration without spatial organization (21.4%), 8 some non-specific abnormalities or questionable elements (19%), 4 focal or diffuse epileptic EEG abnormalities including one related to symptomatic focal epilepsy related to stroke prior to SARS-CoV-2 infection (9.5%)
On 33% of patients with confusion or psychomotor alterations, two EEG were normal with drowsiness, 3 EEGs were slowed but one under midazolam, 4 had some abnormal nonspecific features, two had epileptic anomalies (one with rolandic epileptic abnormalities or lateralized epileptiform discharges at 1 Hz (LPDs) probably more related to a previous stroke, not fullfing criteria for non-convulsive status epilepticus; and one with a status epilepticus solved with intravenous clonazepam injection) and 3 had an encephalopathic pattern
Summary
The current pandemic viral infection with coronavirus 2 (SARS-CoV-2) appears to have, as its initial target, the respiratory tract inducing acute respiratory distress syndrome, in elderly subjects with certain risk factors including diabetes, immunosuppression, and chronic renal and respiratory failure. As with any severe viral infection, there is a risk of dissemination to the central nervous system with general neurological symptoms such as fatigue, headache, confusion, myalgia, and anosmia and agueusia [1]. Neurological impairments may result in an encephalopathy, meningoencephalitis, necrotizing encephalitis [2] documented by imaging [3] and lumbar puncture [4] and may be accompanied by epileptic seizures or stroke [5, 6]. This neurological impairment seems to be correlated with the severity of the infection [7]. The virus could cross the blood-brain barrier and bind to hACE2
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
