Post-COVID seizure: A new feature of “long-COVID”

Kincaid, Keith J.; ChiKung, Justin; Senetar, Alexander J.; Mendoza, David; Bonnin, Daniel A.; Purtlebaugh, Windy L.; Cabatbat, Rainier M.; Dickens, Rondalyn; Echevarria, Franklin D.; Kariyawasam, Vidhu; Bruzzone, Maria; Simpkins, Alexis N.

Novel coronavirus SARS-CoV-2 has created unprecedented healthcare challenges. Neurologic deficits are often an important presenting symptom. To date, the only reported post-infectious COVID-19 manifestations of neurologic disease include cognitive deficits and dysfunction of the peripheral nervous system. Here we report that seizure can also be a post-COVID-19 or “long-COVID” complication. We present a 71-year-old man with hypertension, diabetes mellitus, and COVID-19 diagnosed by RT-PCR who initially presented with posterior circulation stroke-like symptoms, which completely resolved after emergent thrombolysis. Six days later, the patient returned with seizure activity, supported by radiographic and electroencephalographic studies. Notably, he was negative for SARS-CoV-2, and no other provoking factor was uncovered after a comprehensive work-up. To our knowledge, this is the first report of post-infectious seizures after a case of COVID-19, highlighting the potential importance of monitoring for neurologic symptoms in COVID-19 patients, even after convalescence.