Generalized onset seizures during COVID-19 infection: Does it mean the diagnosis Epilepsy

Abstract

We present a case report of a 58-year old man who came to our Department of Neurology for a consultation 2 months after being diagnosed with COVID-19 infection. The patient had been febrile for a week and had had 2 generalized onset seizures with clonic jerks of the upper extremities in 2 consecutive days. Then he had been admitted at a department of infection diseases. COVID-19 PCR had been positive. EEG and CT scan of the brain had been absolutely normal. The patient had been treated with azithromycin for the COVID-19 infection and following a negative PCR test, he had gone home. During the hospital stay the patient had been diagnosed with Epilepsy and valproate treatment had been started. The patient did not accept the diagnosis and did not take the anticonvulsant regularly, moreover he was a truck driver and wanted to go back to work shortly. The control EEG showed no abnormalities and he had no more seizures. Therefore we did not accept the diagnosis Epilepsy and did not recommend a regular intake of antiepileptic medications. In conclusion we would like to emphasize on the need of an individual approach to every patient. Provoked seizures which are symptoms of an infection do not necessarily mean a diagnosis Epilepsy and do not require chronic treatment, especially when they are not present after the acute stage and EEG is normal.