COVID-19 Precipitating Status Epilepticus in a Pediatric Patient

Farley, Madison; Zuberi, Jamshed

Patient: Male, 8-year-old Final Diagnosis: COVID-19 Symptoms: Abdominal pain • respiratory distress • status epilepticus • vomiting Medication: — Clinical Procedure: — Specialty: Infectious Diseases • Pediatrics and Neonatology OBJECTIVE: Unusual clinical course BACKGROUND: As the severe acute respiratory syndrome coronavirus 2 (SARS CoV2) spreads around the world infecting people of all ages, clinicians and researchers are working to gather data on the presentation of coronavirus disease (COVID-19). Further study is necessary to better diagnose and treat COVID-19 patients. CASE REPORT: We describe the case of an 8-year-old boy admitted with status epilepticus, who also tested positive for COVID-19, while afebrile, with no initial respiratory symptoms. Benzodiazepines were given per treatment guidelines, abating the seizure activity. He subsequently developed respiratory distress and desaturation requiring temporary emergent intubation. All clinical symptoms resolved within a few hours. Results of a computed tomography (CT) scan of the brain were within normal limits. Results of a 24-h electroencephalogram (EEG) were abnormal, indicative of diffuse cerebral dysfunction. As a result of intubation and findings of bilateral infiltrates on chest x-ray, a COVID-19 test was administered and the result was positive. CONCLUSIONS: For proper diagnosis and treatment, patients and clinicians should be aware that COVID-19 may not present in the typical fashion of respiratory distress and fever. The present case suggests a rare neurological presentation of COVID-19.