Background: Neurological manifestations of COVID-19 have only recently been described, with a paucity of literature reporting the potential relationship between COVID-19 and acute symptomatic seizures. Two prior studies found no clinical or electrographic seizures in their cohorts of COVID-19 patients with altered mental status (AMS) and clinical seizure-like events (SLEs). Methods: In this retrospective cohort study, 22 critically-ill COVID-19 patients above the age of 18 years who underwent EEG (electroencephalography) monitoring between April 20th, 2020 and May 20th, 2020 were studied. 19 patients underwent continuous EEG (cEEG) for at least 24 hours, and 3 patients underwent routine EEGs (<1 hour). Demographics including age, gender, comorbid medical, and neurological conditions were collected. Clinical variables included EEG findings, anti-seizure medications, discharge disposition, and survival. Findings: 17 patients underwent EEG monitoring for unexplained altered mental status changes and 5 patients underwent monitoring for a seizure-like event. 5 patients had epileptiform abnormalities on EEG (4 patients on cEEG, 1 on routine EEG); and only 2 of 5 epileptic EEG patients had a prior history of epilepsy. 2 patients in our cohort had electrographic seizures in the absence of prior epilepsy history. No patients with epileptiform abnormalities or electrographic seizures had acutely abnormal neuroimaging on CT or MRI. Interpretation: Encephalopathic COVID-19 positive patients had a range of EEG abnormalities, and a higher proportion of patients in this series had electrographic seizures than previous literature suggests. This may be influenced by the duration of monitoring with cEEG and the use of a 21 channel electrode system. cEEG findings may help to guide antiseizure medical therapy, as well as the workup of altered mental status in the setting of unremarkable neuroimaging. Funding: No funding was used for this study.

中文翻译：

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COVID-19患者的连续脑电图（cEEG）特征和急性症状性癫痫发作

背景：仅在最近才描述了COVID-19的神经学表现，但缺乏文献报道了COVID-19与急性症状性癫痫发作之间的潜在关系。两项先前的研究发现，在他们的COVID-19患有精神状态改变（AMS）和临床发作样事件（SLE）的患者队列中没有临床或电图发作。方法：在这项回顾性队列研究中，研究了22位18岁以上重症COVID-19患者，他们于2020年4月20日至2020年5月20日接受了EEG（脑电图）监测。19例患者接受了连续EEG（cEEG）至少24小时，而3例患者接受了常规EEG（<1小时）。收集了人口统计信息，包括年龄，性别，合并疾病和神经系统疾病。临床变量包括脑电图结果，抗癫痫药，分泌物处置和生存。研究结果：17例患者接受了EEG监测以了解无法解释的精神状态变化，5例患者接受了癫痫样事件监测。5例脑电图呈癫痫样异常（cEEG 4例，常规EEG 1例）；5例癫痫EEG患者中只有2例曾有癫痫病史。在没有先前癫痫病史的情况下，我们队列中的2例患者出现了电图发作。没有癫痫样异常或电图发作的患者在CT或MRI上无急性神经影像异常。解释：脑病性COVID-19阳性患者具有一系列脑电图异常，并且该系列患者中有比以前的文献更高的电图发作。这可能会受到cEEG监测持续时间以及使用21通道电极系统的影响。cEEG的发现可能有助于指导抗癫痫药物治疗，以及在无明显神经影像学检查的情况下对精神状态改变进行检查。资金：本研究未使用任何资金。