EEG Findings in Coronavirus Disease.

Pilato, Madison S; Urban, Alexandra; Alkawadri, Rafeed; Barot, Niravkumar V; Castellano, James F; Rajasekaran, Vijayalakshmi; Bagić, Anto I; Fong-Isariyawongse, Joanna S

PURPOSE Neurologic manifestations of coronavirus disease (COVID-19) such as encephalopathy and seizures have been described. To our knowledge, detailed EEG findings in COVID-19 have not yet been reported. This report adds to the scarce body of evidence. METHODS We identified eight COVID-19 positive patients who underwent EEG monitoring in our hospital system. RESULTS EEGs were most commonly ordered for an altered level of consciousness, a nonspecific neurologic manifestation. We observed generalized background slowing in all patients and generalized epileptiform discharges with triphasic morphology in three patients. Focal electrographic seizures were observed in one patient with a history of focal epilepsy and in another patient with no such history. Five of eight patients had a previous diagnosis of epilepsy, suggesting that pre-existing epilepsy can be a potential risk factor for COVID-19-associated neurological manifestations. Five of eight patients who underwent EEG experienced a fatal outcome of infection. CONCLUSIONS Our findings underscore previous observations that neurologic manifestations are common in severe cases. COVID-19 patients with epilepsy may have an increased risk of neurological manifestations and abnormal EEG.