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新型冠状病毒肺炎所致癫痫持续状态:病例系列及文献综述

Status epilepticus due to COVID-19; a cases series and literature review.

作者信息

Kheradmand Mohsen, Hemasian Helia, Khorvash Fariborz, Najafi Mohammad Reza, Ghadimi Keyvan, Forouharnejad Khatereh, Najafi Mohammad Amin

机构信息

Isfahan Neurosciences Research Center, Alzahra Hospital, Isfahan University of Medical Sciences Isfahan, Iran.

Department of Neurology, Isfahan University of Medical Sciences Isfahan, Iran.

出版信息

Am J Neurodegener Dis. 2022 Jun 20;11(2):34-45. eCollection 2022.

Abstract

Complications are increasingly recognized with SARS-CoV-2, the causative pathogen for COVID-19. Various mechanisms have been proposed to justify the cause of seizures in Covid-19 patients. To our knowledge, 13 cases of status epilepticus (SE) associated with COVID-19 have been reported so far. Here, we present a single-center case series, including the clinical, laboratory, and imaging characteristics, and the EEG and the outcome of SE in 5 Iranian patients with laboratory-confirmed SARS-CoV-2 virus. SE was para-infectious in four patients and post-infectious in one other patient. In Three patients, the causes of seizure were included severe hyponatremia, acute ischemic stroke, and meningoencephalitis. However, in two other patients, no specific reason for seizure was found, but there are possibilities for lesser-known mechanisms of Covid-19 that play roles in developing SE. Two of the patients recovered, and three patients, older and with higher comorbidities, failed to recover and died.

摘要

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)是冠状病毒病(COVID-19)的致病病原体,人们越来越认识到它会引发并发症。已经提出了各种机制来解释COVID-19患者癫痫发作的原因。据我们所知,迄今为止,已有13例与COVID-19相关的癫痫持续状态(SE)病例报告。在此,我们展示了一个单中心病例系列,包括5例实验室确诊感染SARS-CoV-2病毒的伊朗患者的临床、实验室和影像学特征,以及SE的脑电图和转归情况。4例患者的SE为感染旁发性,另1例为感染后性。3例患者癫痫发作的原因包括严重低钠血症、急性缺血性中风和脑膜脑炎。然而,在另外2例患者中,未发现癫痫发作的具体原因,但可能存在COVID-19鲜为人知的机制在SE的发生中起作用。2例患者康复,3例年龄较大且合并症较多的患者未康复并死亡。

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