Does the Frequency and Etiology of Status Epilepticus Change During the SARS-CoV-2 Pandemic?

Abstract

Objective: There are limited data regarding the development of status epilepticus (SE) in epilepsy patients during the Severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV-2) pandemic. In Turkey, no study has investigated the frequency and etiology of SE in patients with epilepsy during the pandemic period. We aimed to evaluate the etiologies, clinical features, treatment, and prognosis of patients who were followed up with a diagnosis of SE in our neurology clinic and intensive care unit during the pandemic period. Methods: In this study, 59 patients (mean age 51.7±2.7 years), 32 males (54.2%) and 27 females (45.7%), who were monitored and treated in the Bursa City Hospital Neurology Clinic and Neurology Intensive Care Unit between March 11, 2020 and December 31, 2022, were retrospectively included. Results: When etiologic factors leading to SE were analyzed; it was considered that 16 patients had ischemic stroke (27.1%), 8 had intracranial tumor (13.5%), 4 had intracerebral hemorrhage (6.7%), 4 had medication discontinuation (6.7%), 4 had SARS-CoV-2 infection (6.7%), 3 had other infections (5.0%), 2 had SARS-CoV-2 vaccination (3.3%), 4 had previously diagnosed refractory epilepsy (6.7%), and 8 had NORSE (13.5%). In the present study, 18 patients (30%) received IV levetiracetam, 8 patients (13.5%) received levetiracetam + valproic acid, and 6 patients (10.1%) received levetiracetam + phenytoin infusion for SE. We had 28 patients who needed general anesthesia. Ten patients (16.9%) died. Conclusion: In the etiology of SE in our patients monitored during the pandemic period, it was found that ischemic stroke, cryptogenic causes, cerebral hemorrhage, intracranial tumors, SARS-CoV-2 and other infections, and irregular drug use were the most common causes.

Keywords

• sars-cov-2
• covid-19
• epilepsy
• status epilepticus
• pandemic
• etiology