EEG as an indispensable tool during and after the COVID-19 pandemic: A review of tribulations and successes

Abstract

During the coronavirus disease 2019 (COVID-19) pandemic, elective and non-emergent tests and procedures were delayed or suspended in lieu of diverting resources to more emergent treatment of critically ill patients and to avoid the spread and contraction of COVID-19. Further, the workforce was stretched thin, and healthcare facilities saw high turnover rates for full-time and contract employees, which strained the system and reduced the ability to provide clinical services. One of the casualties of these changes was electroencephalography (EEG) procedures, which have been performed less frequently throughout the world since the pandemic. Whether considered routine or emergent, the deferral of EEG studies can cause downstream effects, including a delay in diagnosis and initiation of treatment for epilepsy and non-epileptic seizures resulting in a higher risk of morbidity and mortality. Despite these limitations, the importance and utility of EEG and EEG technologists have been reinforced with the development of COVID-related neurological complications, including encephalopathy and seizures, which require EEG for diagnosis and treatment. Since the pandemic, reliance on remote telemonitoring has further highlighted the value and ease of using EEG. There has also been a heightened interest in rapid EEG devices that non-technologist professionals can attach quickly, allowing minimum patient contact to avoid exposure to COVID-19 and taking advantage of remote EEG monitoring. This review discusses the acute and potential long-term effects of the COVID-19 pandemic on the use and performance of EEG.

The association between epilepsy and COVID-19: analysis based on Mendelian randomization and FUMA

“…However, these findings should be interpreted with caution, as they may be influenced by the substantial obstacles that patients with epilepsy face in obtaining medication and care in various ways, despite the implementation of telehealth guidance during the pandemic ( Rasmusson and Hartshorn, 2005 ; Mueller et al, 2021 ; Pellinen and Holmes, 2022 ). Additionally, the constrained availability of Electroencephalogram (EEG), particularly in epilepsy monitoring units, during the pandemic has compelled the exploration of alternative diagnostic methods, which may have implications for the precise diagnosis of epilepsy and its subtypes ( Freund and Feyissa, 2022 ). In this study, we utilized epilepsy and its subtypes, including focal and generalized epilepsy, as the exposure variables to investigate the potential causal effect of epilepsy on COVID-19 using the MR method.…”

The “Tipping Point” : When Electroencephalography (EEG), Quantitative EEG (QEEG) and Standardized Low Resolution Brain Electromagnetic Tomography (sLORETA) in COVID Went From “Ceasure” To “Non- Priority” To “First-Line” Tool in Triage, Diagnosis, Monitoring and Therapy

“…The resumption of EEG began with the A) implementation of guidelines, to help deal with both non-COVID related prior/incident neurological conditions [9,[32][33][34][35][36][37][38][39][40][41][42][43][44][45] and B) the neurological sequelae due to para-and post-COVID, medication toxicity related to COVID treatment and post-COVID vaccination sequelae [11,[46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64].…”

“…Implementation of COVID appropriate safety guidelines and EEG protocols are mentioned below: [9,[32][33][34][35][36][37][38][39][40][41][42][43][44][45] i. Good medical practice (GMP) hygiene guidelines were defined and established ii.…”

“…Another study stressed the need for awareness among healthcare providers of EEG brainwave morphology in confusion, impaired consciousness, stupor, coma, headaches hypercapnic/hypoxic and anoxic (post-cardiac arrest syndrome) encephalopathies and encephalitides, symptomatic seizures in acute respiratory failure [41]. Emphasis was laid that EEG technical staff, medical students, residents, fellows, clinicians, and neurologists, receive the appropriate training via continuing medical education (CMEs) and webinars in triage, diagnose, differential diagnosis, safety guidelines and treatment protocols to enable them to provide integrated care and to successfully handle incident COVID and neurological sequelae due to para/ acute/post COVID [42][43][44][45].…”

Effect of the COVID-19 Pandemic on Resting-State Brain Activity in Individuals with Tinnitus

“…The COVID-19 pandemic has significantly complicated the process of recording electrical brain activity, particularly the isolation measures required [15]. Other repercussions of the pandemic include less access to participants, difficulty in collecting data, and limited recruitment [16]. Be that as it may, some EEG work performed during prolonged isolation periods has reported that there seems to be decreased alpha power in the restingstate EEG [17].…”