@article{ab4f57d3834a4ff188f50e455a6e02e6,
title = "EEG findings in acutely ill patients investigated for SARS-CoV-2/COVID-19: A small case series preliminary report",
abstract = "Objective: Acute encephalopathy may occur in COVID-19-infected patients. We investigated whether medically indicated EEGs performed in acutely ill patients under investigation (PUIs) for COVID-19 report epileptiform abnormalities and whether these are more prevalent in COVID-19 positive than negative patients. Methods: In this retrospective case series, adult COVID-19 inpatient PUIs underwent EEGs for acute encephalopathy and/or seizure-like events. PUIs had 8-channel headband EEGs (Ceribell; 20 COVID-19 positive, 6 COVID-19 negative); 2 more COVID-19 patients had routine EEGs. Overall, 26 Ceribell EEGs, 4 routine and 7 continuous EEG studies were reviewed. EEGs were interpreted by board-certified clinical neurophysiologists (n = 16). EEG findings were correlated with demographic data, clinical presentation and history, and medication usage. Fisher's exact test was used. Results: We included 28 COVID-19 PUIs (30-83 years old), of whom 22 tested positive (63.6% males) and 6 tested negative (33.3% male). The most common indications for EEG, among COVID-19-positive vs COVID-19-negative patients, respectively, were new onset encephalopathy (68.2% vs 33.3%) and seizure-like events (14/22, 63.6%; 2/6, 33.3%), even among patients without prior history of seizures (11/17, 64.7%; 2/6, 33.3%). Sporadic epileptiform discharges (EDs) were present in 40.9% of COVID-19-positive and 16.7% of COVID-19-negative patients; frontal sharp waves were reported in 8/9 (88.9%) of COVID-19-positive patients with EDs and in 1/1 of COVID-19-negative patient with EDs. No electrographic seizures were captured, but 19/22 COVID-19-positive and 6/6 COVID-19-negative patients were given antiseizure medications and/or sedatives before the EEG. Significance: This is the first preliminary report of EDs in the EEG of acutely ill COVID-19-positive patients with encephalopathy or suspected clinical seizures. EDs are relatively common in this cohort and typically appear as frontal sharp waves. Further studies are needed to confirm these findings and evaluate the potential direct or indirect effects of COVID-19 on activating epileptic activity.",
keywords = "COVID-19, SARS-CoV-2, encephalopathy, epileptiform discharges, seizures",
author = "Galanopoulou, {Aristea S.} and Victor Ferastraoaru and Correa, {Daniel J.} and Koshi Cherian and Susan Duberstein and Jonathan Gursky and Rajani Hanumanthu and Christine Hung and Isaac Molinero and Olga Khodakivska and Legatt, {Alan D.} and Puja Patel and Jillian Rosengard and Elayna Rubens and William Sugrue and Elissa Yozawitz and Mehler, {Mark F.} and Karen Ballaban-Gil and Haut, {Sheryl R.} and Mosh{\'e}, {Solomon L.} and Alexis Boro",
note = "Funding Information: AS Galanopoulou acknowledges grant support by NINDS RO1 NS091170, U54 NS100064, the US Department of Defense (W81XWH‐18‐1‐0612), NICHD U54HD090260, and research funding from the Heffer Family and the Segal Family Foundations and the Abbe Goldstein/Joshua Lurie and Laurie Marsh/Dan Levitz families. DJ Correa is supported in part by the NIH 1U54NS100064 grant. MF Mehler is the Alpern Family Foundation Chair in Developmental Neuroscience and partially funded by grants from the NIH (R01NS096144, R21OD025320, R01NS091519 and U10NS086531). SL Mosh{\'e} is the Charles Frost Chair in Neurosurgery and Neurology and partially funded by grants from NIH U54 NS100064 and NS43209, US Department of Defense (W81XWH‐18‐1‐0612), the Heffer Family and the Segal Family Foundations, and the Abbe Goldstein/Joshua Lurie and Laurie Marsh/Dan Levitz families. The authors wish to acknowledge with gratitude the staff of the EEG Department for their excellent technical expertise and dedication to patients' care in performing these studies during the COVID‐19 pandemic. Funding Information: AS Galanopoulou acknowledges grant support by NINDS RO1 NS091170, U54 NS100064, the US Department of Defense (W81XWH-18-1-0612), NICHD U54HD090260, and research funding from the Heffer Family and the Segal Family Foundations and the Abbe Goldstein/Joshua Lurie and Laurie Marsh/Dan Levitz families. DJ Correa is supported in part by the NIH 1U54NS100064 grant. MF Mehler is the Alpern Family Foundation Chair in Developmental Neuroscience and partially funded by grants from the NIH (R01NS096144, R21OD025320, R01NS091519 and U10NS086531). SL Mosh? is the Charles Frost Chair in Neurosurgery and Neurology and partially funded by grants from NIH U54 NS100064 and NS43209, US Department of Defense (W81XWH-18-1-0612), the Heffer Family and the Segal Family Foundations, and the Abbe Goldstein/Joshua Lurie and Laurie Marsh/Dan Levitz families. The authors wish to acknowledge with gratitude the staff of the EEG Department for their excellent technical expertise and dedication to patients' care in performing these studies during the COVID-19 pandemic. Publisher Copyright: {\textcopyright} 2020 The Authors. Epilepsia Open published by Wiley Periodicals LLC on behalf of International League Against Epilepsy",
year = "2020",
month = jun,
day = "1",
doi = "10.1002/epi4.12399",
language = "English (US)",
volume = "5",
pages = "314--324",
journal = "Epilepsia Open",
issn = "2470-9239",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "2",
}