Post-COVID-19 inflammatory syndrome manifesting as refractory status epilepticus

Elizabeth Carroll; Henry Neumann; Maria E Aguero-Rosenfeld; Jennifer Lighter; Barry M Czeisler; Kara Melmed; Ariane Lewis

doi:10.1111/epi.16683

Post-COVID-19 inflammatory syndrome manifesting as refractory status epilepticus

Epilepsia. 2020 Oct;61(10):e135-e139. doi: 10.1111/epi.16683. Epub 2020 Sep 18.

Authors

Elizabeth Carroll¹, Henry Neumann², Maria E Aguero-Rosenfeld³, Jennifer Lighter⁴, Barry M Czeisler^{1

5}, Kara Melmed^{1

5}, Ariane Lewis^{1

5}

Affiliations

¹ Department of Neurology, NYU Langone Medical Center, New York, New York.
² Department of Medicine, NYU Langone Medical Center, New York, New York.
³ Department of Pathology, NYU Langone Medical Center, New York, New York.
⁴ Department of Pediatrics, NYU Langone Medical Center, New York, New York.
⁵ Department of Neurosurgery, NYU Langone Medical Center, New York, New York.

Abstract

There have been multiple descriptions of seizures during the acute infectious period in patients with COVID-19. However, there have been no reports of status epilepticus after recovery from COVID-19 infection. Herein, we discuss a patient with refractory status epilepticus 6 weeks after initial infection with COVID-19. Extensive workup demonstrated elevated inflammatory markers, recurrence of a positive nasopharyngeal SARS-CoV-2 polymerase chain reaction, and hippocampal atrophy. Postinfectious inflammation may have triggered refractory status epilepticus in a manner similar to the multisystemic inflammatory syndrome observed in children after COVID-19.

Keywords: COVID-19; SARS-CoV-2; inflammatory response; postinfectious; refractory status epilepticus; seizures.

Publication types

Case Reports

MeSH terms

Aged
COVID-19 / complications*
Drug Resistant Epilepsy / virology
Female
Humans
Inflammation / virology*
SARS-CoV-2
Status Epilepticus / virology*
Syndrome