McCauley Caroline S, Li Vivian, Kobrin Steven
Medical School, Lake Erie College of Osteopathic Medicine, Erie, USA.
Internal Medicine, St. John's Episcopal Hospital, Far Rockaway, USA.
Cureus. 2023 Apr 11;15(4):e37438. doi: 10.7759/cureus.37438. eCollection 2023 Apr.
COVID-19 can affect many organ systems, including the CNS, with symptoms of altered mental status and seizures. We present a case of a 30-year-old man with cerebral palsy who developed seizures after a COVID-19 infection. Admission labs were remarkable for hypernatremia, and elevated creatine kinase, and troponin levels as well as creatinine above baseline. MRI was performed demonstrating a small, evolving acute/subacute abnormality in the midline splenium of the corpus callosum. An EEG showed moderate to severe abnormalities with low-voltage delta waves. The patient was treated with medication and advised to follow up with a neurologist. One month later, no residual CT abnormality corresponding to the previously reported lesion in the midline splenium of the corpus callosum was observed. Although epilepsy is a common finding in patients with cerebral palsy, the complete lack of seizure activity throughout this patient's early life, coupled with previously unremarkable brain imaging, further supports our claim that his recent onset of seizures was directly related to COVID-19. This case highlights the possibility of new seizures in patients with pre-existing neurological conditions after COVID-19 infection and emphasizes the need for more research.
新冠病毒病（COVID-19）可影响包括中枢神经系统（CNS）在内的多个器官系统，出现精神状态改变和癫痫发作等症状。我们报告一例30岁脑瘫男性患者，其在感染COVID-19后出现癫痫发作。入院实验室检查显示血钠升高、肌酸激酶及肌钙蛋白水平升高，肌酐高于基线水平。头颅磁共振成像（MRI）显示胼胝体压部中线处有一个小的、正在演变的急性/亚急性异常信号。脑电图显示中度至重度异常，有低电压δ波。患者接受了药物治疗，并被建议随访神经科医生。1个月后，未观察到与先前报告的胼胝体压部中线病变相对应的残留CT异常。虽然癫痫在脑瘫患者中很常见，但该患者早年完全没有癫痫发作活动，且既往脑成像无异常，这进一步支持了我们的观点，即其近期癫痫发作与COVID-19直接相关。该病例凸显了COVID-19感染后有神经系统疾病史的患者出现新发癫痫的可能性，并强调了需要更多研究。
