Prospective studies have reported a seizure prevalence in nonepileptic COVID-19 patients of up to 2%. While infrequent, the presence of acute symptomatic seizures from an underlying metabolic/toxic process or primary CNS insult can manifest as a complication of COVID-19 infection. Two retrospective studies have described electroencephalogram (EEG) patterns seen during acute COVID-19 infection.[63,64] Galanopoulou et al. reported frequent sporadic interictal epileptiform discharges in 22 COVID-19 patients using continuous 8-channel EEGs. However, this finding was not supported by another study using the standard 21-channel EEG. Instead, a variety of other nonepileptic EEG findings, including continuous slowing, generalized rhythmic activity, and generalized periodic discharges, were reported. Given the high incidence of persistent encephalopathy in hospitalized COVID-19 patients, EEG monitoring may help providers screen for a primary neurologic cause.
Curr Opin Infect Dis. 2021;34(3):217-227. © 2021 Lippincott Williams & Wilkins