Abstract Background Coronavirus Disease 2019 (COVID-19) has rapidly become a global pandemic, with over 1.8 million confirmed cases worldwide to date. Preliminary reports suggest that the disease may present in diverse ways, including with neurological symptoms, but few published reports in the literature describe seizures in patients with COVID-19. Objective To characterize the risk factors, clinical features, and outcomes of seizures in patients with COVID-19. Methods Retrospective case series. Cases were identified through a review of admissions and consultations to the neurology and neurocritical care services between April 1, 2020, and May 15, 2020. Setting A tertiary care, safety-net hospital in Boston, MA. Participants Patients presenting with seizures and COVID-19 during the study period. Results Seven patients met inclusion criteria (5 female, 71%). Patients ranged in age from 37 to 88 years (median 75 years). Three patients had a prior history of well-controlled epilepsy (43%), while 4 patients had new-onset seizures, including 2 patients with prior history of remote stroke. Three patients had no preceding symptoms of COVID-19 prior to presentation (57%), and in all cases, seizures were the symptom that prompted presentation to the emergency department, regardless of prior symptoms of COVID-19. Conclusions Provoking factors for seizures in patients with COVID-19 may include metabolic factors, systemic illness, and possibly direct effects of the virus. In endemic areas with community spread of COVID-19, clinicians should be vigilant for the infection in patients who present with seizures, which may precede respiratory symptoms or prompt presentation to medical care. Early testing, isolation and contact tracking of these patients can prevent further transmission of the virus.

中文翻译：

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癫痫作为 COVID-19 的主要症状：回顾性病例系列

摘要背景 2019 年冠状病毒病 (COVID-19) 已迅速成为全球大流行病，迄今为止，全球已确诊病例超过 180 万。初步报告表明，该疾病可能以多种方式出现，包括神经系统症状，但文献中很少有已发表的报告描述了 COVID-19 患者的癫痫发作。目的 表征 COVID-19 患者癫痫发作的危险因素、临床特征和结果。方法回顾性病例系列。通过对 2020 年 4 月 1 日至 2020 年 5 月 15 日期间神经病学和神经重症监护服务的入院和咨询情况进行审查，确定了病例。 地点 位于马萨诸塞州波士顿的一家三级医疗安全网医院。参与者 在研究期间出现癫痫和 COVID-19 的患者。结果 7 名患者符合纳入标准（5 名女性，71%）。患者的年龄从 37 岁到 88 岁不等（中位数为 75 岁）。3 名患者既往有控制良好的癫痫病史 (43%)，而 4 名患者有新发癫痫发作，包括 2 名既往有远距离卒中史的患者。三名患者在就诊前没有 COVID-19 的先前症状 (57%)，并且在所有情况下，癫痫是促使就诊于急诊科的症状，无论先前的 COVID-19 症状如何。结论 COVID-19 患者癫痫发作的诱发因素可能包括代谢因素、全身性疾病以及病毒可能的直接影响。在 COVID-19 社区传播的流行地区，临床医生应警惕癫痫患者的感染，这可能先于呼吸道症状或立即就医。对这些患者进行早期检测、隔离和接触者追踪可以防止病毒的进一步传播。