Seizure control during the COVID-19 pandemic: Correlating Responsive Neurostimulation System data with patient reports.

OBJECTIVE

To understand the impact of the Coronavirus Disease-2019 (COVID-19) pandemic on seizure frequency in persons with epilepsy with a Responsive Neurostimulation (RNS) system implanted.

METHODS

Weekly long episode counts (LEC) were used as a proxy for seizures for six months pre-COVID-19 and during the COVID-19 period. Telephone surveys and chart reviews were conducted to assess patient mental health during the pandemic. The change in LEC between the two time periods was correlated to reported stressors.

RESULTS

Twenty patients were included. Comparing the pre-COVID-19 period to the COVID-19 period, we found that only 5 (25%) patients had increased seizures, which was positively correlated with change in anti-seizure medications (ASM, p = 0.03) and bitemporal seizures (p = 0.03). Increased seizures were not correlated to anxiety (p = 1.00), depression (p = 0.58), and sleep disturbances (p = 1.00). The correlation between RNS-detected and patient-reported seizures was poor (p = 0.32).

CONCLUSIONS

Most of our patients did not have an increase in seizures following the COVID-19 pandemic. Changes in ASM and bitemporal seizures were positively correlated to increased LEC. There was no correlation between pandemic-related stress and seizures in those found to have increased seizures.

SIGNIFICANCE

This is the first study correlating RNS-derived objective LECs with patient self-reports and potential seizure risk factors during the COVID-19 pandemic.