Prevalence, clinical, imaging, electroencephalography and laboratory characteristics of seizures in COVID-19

Keyvan Ghadimi; Zohreh Heidari; Mohsen Kheradmand; Mohammad Amin Najafi; Ahmad Chitsaz; Fariborz Khorvash; Maryam Fahim; Mohammad Reza Najafi

Prevalence, clinical, imaging, electroencephalography and laboratory characteristics of seizures in COVID-19

Am J Neurodegener Dis. 2022 Oct 15;11(3):46-54. eCollection 2022.

Authors

Keyvan Ghadimi¹, Zohreh Heidari², Mohsen Kheradmand², Mohammad Amin Najafi², Ahmad Chitsaz², Fariborz Khorvash², Maryam Fahim¹, Mohammad Reza Najafi²

Affiliations

¹ School of Medicine, Isfahan University of Medical Sciences Isfahan, Iran.
² Department of Neurology, School of Medicine, Isfahan University of Medical Sciences Isfahan, Iran.

PMID: 36419954
PMCID: PMC9678745

Abstract

Background: COVID-19 is the cause of the recent pandemic. Viral infections could increase the risks of neurological impairments, including seizures. Here, we aimed to evaluate the prevalence, clinical, imaging, electroencephalography and laboratory characteristics of seizures in COVID-19.

Methods: This retrospective cross-sectional study was performed on cases of COVID-19 infection and seizure. The prevalence of seizures in patients with COVID-19 was calculated using the incidence of seizures in all patients. The collected data were age, sex, history of previous illnesses, the severity of COVID-19 disease, patients' medications, hospitalization, and the presence of electrolyte disorders in patients' tests and other tests such as blood gas. Those patients with their first seizure episodes were also divided into two groups of cases with COVID-19 associated seizures (N=38) and non-COVID-19 associated seizures (N=37) and the mentioned data were compared between the two groups.

Results: We assessed data of 60 patients with COVID-19-associated seizures (group 1), 40 patients with seizures not related to COVID-19 (group 2) and 60 patients with COVID-19 infection and no seizures (group 3). The prevalence of hypertension and diabetes mellitus were significantly higher in group 3 compared to group 1 (P=0.044 and P=0.009, respectively). Still, patients in group 1 had a higher prevalence of cerebrovascular accidents (CVA) compared to group 3 (P=0.008). The prevalence of abnormal EEG was significantly higher in cases with COVID-19 infection compared to the other group (P<0.001). Cases with their first seizure episode associated with COVID-19 had significantly higher creatinine levels (P=0.035), lower blood pH (P=0.023), lower blood HCO3 (P=0.001), higher ALT (P=0.004), higher blood urea nitrogen (BUN) (P=0.001), lower hemoglobin (Hb) (P=0.017), higher ESR (P=0.001), higher CRP (P<0.001) and higher mortality rates (P=0.004).

Conclusion: Patients with COVID-19 infection and seizure have higher mortality rates and disturbed laboratory data.

Keywords: COVID-19; epilepsy; pandemic; seizure.