Pediatric neurology unit, Hadassah medical center, Jerusalem, Israel.
School of medicine, the Hebrew university of Jerusalem, Israel; Pediatric emergency department, Hadassah medical center, Jerusalem, Israel.
Seizure. 2021 Nov;92:89-93. doi: 10.1016/j.seizure.2021.08.017. Epub 2021 Aug 28.
To explore the rate, characteristics, risk factors, and prognosis of children presenting with seizures as the main symptom of acute COVID-19 (coronavirus disease 2019).
We conducted a systematic retrospective study to identify all children who presented to the emergency departments of a tertiary academic medical center between March 1st and December 31st 2020 and had a SARS-CoV-2 infection based on RT-PCR (reverse transcription-polymerase chain reaction) from nasopharyngeal swab. Clinical and demographic data were extracted from the electronic medical records and reviewed.
Total of 175 children were diagnosed with acute SARS-CoV-2 infection in the emergency departments during the study period. Of those, 11 presented with seizures. Age ranged from six months to 17 years and 4 were girls. Five presented with status epilepticus and responded to loading doses of anti-seizure medications. Six had fever. Seven had prior history of neurological disorder. Full recovery was the rule.
Unlike in adults, seizures occur early and may be the main manifestation of acute COVID-19 in children. Seizures, including status epilepticus, may occur without fever even in children with no history of epilepsy and are not associated with severe disease. A high index of suspicion is required for early diagnosis thus infection control measures can be taken.
探讨以癫痫发作为主要表现的急性 COVID-19（2019 年冠状病毒病）患儿的发病情况、特征、危险因素和预后。
我们进行了一项系统的回顾性研究，以确定在 2020 年 3 月 1 日至 12 月 31 日期间，因 SARS-CoV-2 感染而在三级学术医疗中心的急诊科就诊并通过鼻咽拭子 RT-PCR（逆转录-聚合酶链反应）检测呈阳性的所有儿童。从电子病历中提取临床和人口统计学数据并进行回顾。
在研究期间，共有 175 名儿童在急诊科被诊断为急性 SARS-CoV-2 感染。其中 11 名患儿出现癫痫发作。年龄从 6 个月至 17 岁不等，其中 4 名为女孩。5 名患儿出现癫痫持续状态，给予抗癫痫药物负荷剂量后得到缓解。6 名患儿有发热。7 名患儿有既往神经疾病史。患儿均完全康复。
与成人不同，儿童的癫痫发作发生较早，可能是急性 COVID-19 的主要表现。癫痫发作，包括癫痫持续状态，即使在无癫痫病史的儿童中也可能无发热发生，且与严重疾病无关。因此，需要高度警惕，以便早期诊断，从而采取感染控制措施。
