CHU Lille, Department of Clinical Neurophysiology, F-59000 Lille, France.
CHU Lille, Department of Clinical Neurophysiology, F-59000 Lille, France; CHU Lille, Department of Intensive Care, F-59000 Lille, France.
Clin Neurophysiol. 2021 May;132(5):1009-1017. doi: 10.1016/j.clinph.2021.02.007. Epub 2021 Feb 25.
To describe EEG patterns of critical Coronavirus Disease 2019 (COVID-19) patients with suspicion of encephalopathy and test their association with clinical outcome.
EEG after discontinuation of sedation in all patients, and somesthesic evoked potentials and brainstem auditive evoked potentials when EEG did not show reactivity, were performed. Clinical outcome was assessed at day 7 and 14 after neurophysiological explorations.
33 patients were included for analysis. We found slowed background activity in 85% of cases, unreactive activity in 42% of cases, low-voltage activity in 21% of cases and rhythmic or periodic delta waves in 61% of cases. EEG epileptic events were never recorded. Clinical outcome at day 14 was associated with unreactive background activity and tended to be associated with rhythmic or periodic delta waves and with low-voltage activity. Results of multimodal evoked potentials were in favor of a preservation of central nervous system somatosensory and auditory functions.
Among critical COVID-19 patients with abnormal arousal at discontinuation of sedation, EEG patterns consistent with encephalopathy are found and are predictive for short term clinical outcome.
The abnormal EEG with presence of periodic discharges and lack of reactivity could be related to encephalopathy linked to COVID-19.
描述疑似脑病的危重新冠病毒病（COVID-19）患者的脑电图（EEG）模式，并检验其与临床转归的关系。
对所有患者镇静停止后进行 EEG 检查，若 EEG 无反应则进行体感诱发电位和脑干听觉诱发电位检查。在神经生理检查后第 7 天和第 14 天评估临床转归。
共纳入 33 例患者进行分析。我们发现 85%的病例背景活动减慢，42%的病例反应性活动丧失，21%的病例低电压活动，61%的病例出现节律性或周期性δ波。从未记录到 EEG 癫痫事件。第 14 天的临床转归与无反应性背景活动相关，且与节律性或周期性δ波以及低电压活动相关。多模态诱发电位的结果提示中枢神经系统体感和听觉功能的保留。
在镇静停止时出现异常觉醒的危重新冠病毒病患者中，存在与脑病一致的脑电图模式，且与短期临床转归相关。
存在周期性放电和无反应性的异常 EEG 可能与 COVID-19 相关的脑病有关。
