Kincaid Keith J, Kung Justin C, Senetar Alexander J, Mendoza David, Bonnin Daniel A, Purtlebaugh Windy L, Cabatbat Rainier M, Dickens Rondalyn, Echevarria Franklin D, Kariyawasam Vidhu, Bruzzone Maria, Simpkins Alexis N
University of Florida, Department of Neurology, Gainesville, FL, USA.
Medstar Washington Hospital Center, Comprehensive Stroke Center, Washington, DC, USA.
eNeurologicalSci. 2021 Jun;23:100340. doi: 10.1016/j.ensci.2021.100340. Epub 2021 Apr 18.
Novel coronavirus SARS-CoV-2 has created unprecedented healthcare challenges. Neurologic deficits are often an important presenting symptom. To date, the only reported post-infectious COVID-19 manifestations of neurologic disease include cognitive deficits and dysfunction of the peripheral nervous system. Here we report that seizure can also be a post-COVID-19 or "long-COVID" complication. We present a 71-year-old man with hypertension, diabetes mellitus, and COVID-19 diagnosed by RT-PCR who initially presented with posterior circulation stroke-like symptoms, which completely resolved after emergent thrombolysis. Six days later, the patient returned with seizure activity, supported by radiographic and electroencephalographic studies. Notably, he was negative for SARS-CoV-2, and no other provoking factor was uncovered after a comprehensive work-up. To our knowledge, this is the first report of post-infectious seizures after a case of COVID-19, highlighting the potential importance of monitoring for neurologic symptoms in COVID-19 patients, even after convalescence.
新型冠状病毒SARS-CoV-2带来了前所未有的医疗挑战。神经功能缺损往往是一个重要的首发症状。迄今为止,唯一报道的感染后新冠病毒病的神经系统疾病表现包括认知缺陷和周围神经系统功能障碍。在此我们报告癫痫发作也可能是新冠病毒病康复后或“长新冠”的并发症。我们介绍了一名71岁男性,患有高血压、糖尿病,经逆转录聚合酶链反应(RT-PCR)确诊为新冠病毒病,最初表现为后循环卒中样症状,紧急溶栓后症状完全缓解。六天后,患者再次出现癫痫发作,影像学和脑电图检查支持这一诊断。值得注意的是,他的新冠病毒检测呈阴性,全面检查后未发现其他诱发因素。据我们所知,这是新冠病毒病病例后感染性癫痫发作的首例报告,强调了对新冠病毒病患者即使在康复后仍需监测神经症状的潜在重要性。