Answer to seizures: The pediatric Covid-19 infection

Aim: The purpose of the current study was to collect data on the occurrence of seizures in children with COVID-19 and to clarify the circumstances of the occurrence of seizures in these patients.

Method: Fifteen children were included in the study who were referred to the Medical Faculty of Akdeniz University, Department of Pediatric Neurology, and had confirmed Covid-19 infection by PCR tests and seizure. Children presented with status epilepticus(SE), and increased frequency of an epileptic seizures, and new-onset epileptic seizures. The demographical, clinical and laboratory tests were re-evaluated from the hospital records retrospectively.

Results: Eight (53.3 %) of them had been following the diagnosis of epilepsy. Three of the patients with the diagnosis of epilepsy were admitted to the pediatric intensive care unit with status epilepticus. One of the patients had discontinued antiepileptic treatment but seizure recurrence was observed during COVID-19 infection. Seven patients experienced seizures for the first time. Six of them presented with seizures, got diagnosis of COVID-19 infection by PCR tests. One of the children got the diagnosis with paroxysmal nocturnal hemoglobinuria during hospitalization, 2 days after the seizure. Two (28.7%) of them had simple febrile status epilepticus.

Conclusion: Seizure is one of the symptoms of COVID-19 in pediatric ages. It is known that Pro-inflammatory cytokines cause neuronal hyper-excitation. Cytokine-storm in the brain is the most important reason for new onset seizure or seizures in patients previously diagnosed with epilepsy.
Keywords: Covid-19, febrile seizure, epilepsy