New-Onset Refractory Status Epilepticus Secondary to COVID-19 Infection in Adults: A Systematic Review

Abstract

Background New-onset refractory status epilepticus (NORSE) has been reported in the scientific literature as a phenomenon associated with the COVID-19 infection. Given the resurgence of the newer variants of COVID-19 added with its multi-system manifestations, this project was conducted to study the clinical picture of NORSE secondary to COVID-19 infection. Methods Three electronic databases were searched using an extensive search strategy from November 2019 to December 2021. Patients reporting NORSE secondary to COVID-19 were included in this review. The status epilepticus severity score (STESS) was calculated by the study authors for individual patients. Statistical analysis was performed using SPSS version 26 with a p -value <0.05 as statistically significant. Results After screening, 12 patients were included in this study with a mean age of 61.6 ± 19.0-year olds. The most common type of status epilepticus reported in our study population was non-convulsive status epilepticus (NCSE) (7 out of 12 patients, 58.3%). The linear regression model revealed that STESS scores were significantly influenced by patients’ age ( p = 0.004) and intra-hospital occurrence (IHO) of status epilepticus ( p = 0.026). Overall, 8 patients (66.7%) were discharged without complications. Conclusion Given the observed association of STESS with the aging population and IHO of status epilepticus, special attention is due to the caretakers of this population, while further studies are needed to further build upon this review.

Therapierefraktäre Epilepsia partialis continua während einer SARS-CoV-2-Infektion

“…Der häufigste Typ des Status war dabei der non-konvulsive Status, das Durchschnittsalter der erkrankten Personen lag bei 61,6 Jahren, in 53,3 % der Fälle lag eine Komorbidität (Diabetes mellitus, arterielle Hypertonie, Niereninsuffizienz) vor. Im von uns geschilderten Fall fanden sich eine klinisch und liquorchemisch nachgewiesene Demenz vom Alzheimertyp und im Liquor der Nachweis von Anti-Yo-Antikörpern 2 . Neben einer Vorschädigung des Gehirns scheint als Pathomechanismus, der auslösend für einen Status epilepticus sein kann, ein „Zytokin-Sturm“ zu sein 3 .…”

“…Einleitung SARS-CoV-2-Infektionen können mit neurologischen Komplikationen wie einem neu aufgetretenen Status epilepticus einhergehen [1][2][3]. Paraneoplastische Syndrome treten im Zusammenhang mit Tumorerkrankungen auf.…”

“…Die Epilepsia partialis continua wurde im Jahr 1894 von dem russischen Arzt Kojewnikoff erstmalig beschrieben. Die Epilepsia partialis continua ist definiert durch kontinuierliche epileptische Anfälle (motorisch oder sensibel) bei erhaltenem Bewusstsein, die mindestens 1 Stunde anhalten [2]. Epilepsia partialis continua soll häufiger bei Männern auftreten und wird mit einer Häufigkeit von max.…”

Potential risk of liver injury in epileptic patients during COVID-19 pandemic

“…Considering the undesirable response to ASMs, plasma exchange, intravenous immunoglobulin, steroids and immunosuppressives have been used for management of these patients with different success rates. There is no definite approach to manage these patients and the suggested treatment algorithm should be modified individually based on patient’s conditions[ 29 ].…”

“…Many patients with autoimmune epilepsy are under treatment with corticosteroids and other immunosuppressive drugs which might affect the defense ability of immune system[ 24 ]. On the other hand, seizure and status epilepticus as neurological manifestations of COVID-19 have been reported in patients with and without epilepsy[ 25 - 29 ]. In certain types of epilepsy particularly Dravet syndrome, fever might trigger seizures.…”