COVID-19 remains a problem around the world, and many health facilities are seeing new surges of infections. In addition to the respiratory issues associated with COVID, many researchers are trying to better understand viral infections of the nervous system. Researchers are interested in the EEG findings in viral encephalitis/encephalopathy related to COVID-19.
Neurological Issues and COVID
There have been neurological complications reported in 34.6% of patients who have severe COVID. This includes problems like seizures, stroke, and headaches. During the pandemic, a range of studies was conducted on the EEG profile of patients with the coronavirus. There have been reports with just one case studied, as well as reports with up to 111 EEGs. The results of the studies were varied.
Because the studies tended to look at different demographics or certain aspects of the EEG, some researchers wanted to put them together to create a fuller picture of what was happening with different groups. The result was research published in Seizure: European Journal of Epilepsy in October of 2020. The study discussed a systematic review of 84 studies of EEG findings in COVID-19 encephalopathy.
How The Research Was Conducted
The team looked at a wide range of different journals, including PubMed and Google Scholar, to find reports for EEG patients who had COVID-19. They ended up with 84 pieces they could use in the systematic study. There were 617 patients across all of these retrospective studies they used.
The researchers conducted a systematic analysis for age, sex, EEG type, imaging abnormalities, and EEG co-morbid neurological conditions. In some cases, not all of the information was available for the study. They classified the EEG abnormalities, if they arose, into three categories—background abnormalities, periodic and rhythmic EEG patterns, and other epileptiform changes and seizures/status epilepticus.
The median age of patients was 61.3 years old. Most of the patients had routine EEGs, although 28.6% had continuous EEGs. There were five categories for EEG indications:
- Altered mental status – 61.7%
- Seizure-like events – 31.2%
- Cardiac arrest – 3.5%
- Speech issues – 1.7%
- Unspecified – 1.9%
The most common reason for the doctors to order an EEG was for patients who had an altered mental status, followed most closely by those who had a seizure or seizure-like event.
Some of the neurological conditions that were reported and that could affect the EEG included dementia, stroke, Parkinson’s disease, subdural hematoma, epilepsy, hydrocephalus, cognitive delay, traumatic brain injury, brain tumors, anoxia, and Creutzfeldt-Jakob disease.
The most common background abnormality that was discovered was diffuse slowing. This accounted for 68.6% of the patients. However, there were other abnormalities discovered, as well focal slowing accounted for 17% of the patients. Other background abnormalities that were found include slowing of PDR, absent PDR, attenuation, discontinuous EEG, asymmetry, and decreased reactivity.
Incidences in Children
The researchers were only able to find 14 EEG reports for children. The age of the children ranges from 28 days to 16 years. They believe that since there were fewer instances of children found, it could mean that there is a lower incidence of COVID and neurological problems with that age group.
EEG Remains an Important Tool
EEG is important when it comes to helping patients with neurological manifestations of COVID. This is especially true with patients with seizures, status epilepticus, and encephalopathy.
The researchers feel that it is important for doctors who are working in clinics to be aware of and able to identify these types of findings. It can help them to note these types of issues with their patients sooner, which can help ensure they are getting the right type of treatment and care.