HealthDay News — Seizures and other epileptiform abnormalities are common in patients with COVID-19 undergoing clinically indicated continuous electroencephalogram (cEEG) monitoring and are associated with adverse clinical outcomes, according to a study published online March 11 in Annals of Neurology.

Lu Lin, MD, PhD, from the Beth Israel Deaconess Medical Center in Boston, and colleagues assessed 197 patients with COVID-19 referred for cEEG at 9 participating centers to characterize the incidence of and clinical risk factors for seizures.

The researchers found that 9.6% of patients had electrographic seizures, including nonconvulsive status epilepticus (NCSE) in 5.6% of patients. Nearly half (48.7%) had epileptiform abnormalities (either ictal or interictal) present. There was an association noted between clinical seizures during hospitalization prior to initiation of EEG monitoring and both electrographic seizures (odds ratio [OR], 6.51) and NCSE (OR, 8.34). NCSE was also associated with a preexisting intracranial lesion on neuroimaging (OR, 4.33). Electrographic seizures were found to be an independent predictor of in-hospital mortality (hazard ratio, 4.07).


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“We found that seizures indeed can happen in patients with COVID-19 critical illness, even those without any prior neurologic history, and that they are associated with worse outcomes: higher rates of death and longer hospital stay, even after adjusting for other factors,” a coauthor said in a statement. “Our results suggest that patients with COVID-19 should be monitored closely for nonconvulsive seizures. Treatments are available and warranted in patients at high risk; however, further research is needed to clarify how aggressively to treat seizures in COVID-19.”

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