Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Trieste University Hospital-ASUGI, University of Trieste, Strada di Fiume, 447-34149, Trieste, Italy.
Department of Engineering and Architecture, University of Trieste, Via Alfonso Valerio, 10, Trieste, Italy.
J Neurol. 2021 Oct;268(10):3569-3573. doi: 10.1007/s00415-021-10468-y. Epub 2021 Mar 11.
Neurological manifestations may be common in COVID-19 patients. They may include several syndromes, such as a suggested autoimmune abnormal response, which may result in encephalitis and new-onset refractory status epilepticus (NORSE). Quickly recognizing such cases and starting the most appropriate therapy is mandatory due to the related rapid worsening and bad outcomes. This case series describes two adult patients admitted to the university hospital and positive to novel coronavirus 2019 (SARS-CoV-2) infection who developed drug-resistant status epilepticus. Both patients underwent early electroencephalography (EEG) assessment, which showed a pathological EEG pattern characterized by general slowing, rhythmic activity and continuous epileptic paroxysmal activity. A suspected autoimmune etiology, potentially triggered by SARS-CoV-2 infection, encouraged a rapid work-up for a possible autoimmune encephalitis diagnosis. Therapeutic approach included the administration of 0.4 g/kg intravenous immunoglobulin, which resulted in a complete resolution of seizures after 5 and after 10 days, respectively, without adverse effects and followed by a normalization of the EEG patterns.
神经系统表现可能在 COVID-19 患者中较为常见。它们可能包括几种综合征，如疑似自身免疫异常反应，这可能导致脑炎和新发难治性癫痫持续状态（NORSE）。由于相关的快速恶化和不良结局，快速识别此类病例并开始最适当的治疗是强制性的。本病例系列描述了两名成年患者，他们因新型冠状病毒 2019（SARS-CoV-2）感染而住进大学医院，并对其进行了检测，结果呈阳性，他们患有耐药性癫痫持续状态。两名患者均接受了早期脑电图（EEG）评估，结果显示出一种以广泛减慢、节律性活动和持续癫痫发作性活动为特征的病理性 EEG 模式。疑似自身免疫病因，可能由 SARS-CoV-2 感染引发，促使迅速进行可能的自身免疫性脑炎诊断。治疗方法包括给予 0.4g/kg 静脉注射免疫球蛋白，分别在 5 天和 10 天后完全缓解癫痫发作，没有不良反应，并随后 EEG 模式恢复正常。
