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Abstract Details

Status epilepticus and other epileptiform EEG findings in patients with COVID-19
Epilepsy/Clinical Neurophysiology (EEG)
Epilepsy/Clinical Neurophysiology (EEG) Posters (7:00 AM-5:00 PM)
054
To assess electroencephalogram (EEG) findings in patients with COVID-19 infection. 

Neurological manifestations from SARS-CoV-2 infection, commonly known as COVID-19, include impaired consciousness, strokes, and seizures. Emerging evidence shows epileptiform activity is more common than previously reported.

We retrospectively identified 12 patients with COVID-19 infection presenting from June-September 2020 monitored on EEG. All patients underwent either continuous video EEG and/or Ceribell™ rapid response EEG. Demographic data, EEG indication, EEG duration, EEG findings, presence of seizures and deceased status were collected and analyzed.
Demographics were as follows: median age 55 (range: 31-87), including 4 females and 8 males. There were 22 EEG records amongst the 12 patients (15 Ceribells and 7 continuous video EEGs). Indications for EEG were: clinical seizure activity (n=4), cooling post cardiac arrest (n=2), and encephalopathy (n=16).  Duration of recording ranged from 2 hours to 2 days. Status epilepticus was found in 3 patients. Epileptiform activity was found in 10 records, including generalized periodic discharges (n=6 records) and focal epileptiform discharges (n=4 records). Importantly, EEG revealed epileptiform activity in 6 unique patients (50% of patients, and n=12 recordings (55% of recordings)). Focal slowing was found in 8 records. Other EEG findings included diffuse slowing (n=20) and generalized rhythmic delta activity (n=8). Of note, not a single EEG was normal. No patient had a prior history of seizures. Imaging findings included infarct (n=3), microhemorrhage (n=1), multifocal brain lesions (n=1), and empyema (n=1). Six patients died. EEG and clinical symptoms improved with anti-seizure medications.
We describe EEG findings including status epilepticus, epileptiform discharges, and focal slowing in patients with COVID-19 without prior history of seizures. Fifty percent of patients and 55% of total recordings contained epileptiform activity including 3 patients with status epilepticus. EEG recordings in patients with COVID-19 are highly likely to capture epileptiform abnormalities that would benefit from treatment.
Authors/Disclosures
Katherine Werbaneth, MD (Stanford University Medical Center)
PRESENTER 		Dr. Werbaneth has nothing to disclose.
Wendy Chen, MD (Kaiser Permanente) Dr. Chen has nothing to disclose.
Sheela Toprani, MD, PhD Dr. Toprani has nothing to disclose.
Jessica Falco-Walter, MD, FÂ鶹´«Ã½Ó³»­ (Stanford University) Dr. Falco-Walter has nothing to disclose.