The rapid spread of the SARS‐CoV‐2 pandemic poses particular challenges to the management of persons with chronic disease. Reports of a possible neuroinvasiveness of SARS‐CoV‐2 as well as pathophysiological mechanisms and indirect consequences in severe COVID‐19 cases raise the question of whether the infection can be associated with an increased risk of seizure recurrence or the development of new onset and acute symptomatic seizures. Although the literature does not provide relevant evidence for seizure worsening in persons with epilepsy during the course of a SARS‐CoV‐2 infection, there are theoretical risks, for example, seizures triggered by fever. Moreover, a severe disease course and advanced disease stages can, for instance, result in hypoxic encephalopathy, cerebrovascular events, and cytokine storm, which may trigger the development of acute seizures. This is further confirmed by reports of occasional seizures in COVID‐19 patients. Although the low number of reports so far suggests that the risk may be relatively low, the reports indicate that an early neurological manifestation with seizures should not be ruled out. In the context of these cases, we discuss possible pathophysiological mechanisms that may trigger ictogenesis in patients with SARS‐CoV‐2 infection.

中文翻译：

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COVID-19 和癫痫发作：有链接吗？

SARS-CoV-2 大流行的迅速蔓延给慢性病患者的管理带来了特殊挑战。SARS-CoV-2 可能的神经侵袭性以及严重 COVID-19 病例的病理生理机制和间接后果的报告提出了一个问题，即感染是否与癫痫复发风险增加或新发作和急性发作的发展有关。有症状的癫痫发作。尽管文献没有提供有关 SARS-CoV-2 感染过程中癫痫患者癫痫发作恶化的相关证据，但存在理论上的风险，例如发烧引发的癫痫发作。此外，严重的病程和晚期疾病可能导致缺氧性脑病、脑血管事件和细胞因子风暴，这可能会引发急性癫痫发作的发展。COVID-19 患者偶尔癫痫发作的报告进一步证实了这一点。尽管迄今为止的报告数量很少表明风险可能相对较低，但报告表明不应排除癫痫的早期神经系统表现。在这些病例的背景下，我们讨论了可能触发 SARS-CoV-2 感染患者发生 ictogenesis 的可能病理生理机制。