Clinical Evidence of COVID-19 Neurology and Importance of EEG

The recent clinical evidence shows that COVID-19 negatively affects the functioning of the central nervous system.  Moreover, the degree of influence depends on the severity of the course of the disease.  In critically ill patients, who have been in intensive care for a long time, even severe damage to the central nervous system is observed up to the appearance of non-convulsive epileptic seizures.  The EEG method allows monitoring the state of the central nervous system of such patients and timely applying the necessary treatment methods in order to prevent severe consequences of the disease.

Here are some of the clinical papers, with corresponding citations, that describe the importance of the EEG method to diagnose patients with COVID-19:

Systematic review of EEG findings in 617 patients diagnosed with COVID-19

“EEG abnormalities are common in COVID-19 related encephalopathy and correlates with disease severity, preexisting neurological conditions including epilepsy and prolonged EEG monitoring. Frontal findings are frequent and have been proposed as a biomarker for COVID-19 encephalopathy.”

EEG findings in COVID-19 related encephalopathy

“In conclusion, our observations confirm the high sensitivity of the EEG and its localization value in encephalopathies, contributing to unravel also mild cases of COVID-19 related brain dysfunction. In detail, we have shown that COVID-19 related encephalopathy may be associated with a rather homogeneous EEG pattern consisting of a diffuse slowing of the background activity and loss of reactivity to external stimuli. Whether or not these EEG findings may be specific for COVID-19 related encephalopathy is unknown and deserves further investigation.”

COVID-19 associated encephalopathy: Is there a specific EEG pattern?

“We report the history of two patients with coronavirus infectious disease 2019 (COVID-19) whose electroencephalograms (EEG) found a unique pattern, never described up to now.”

Status epilepticus and other EEG findings in patients with COVID-19: A case series

“Status epilepticus was present in 2 out of our cohort of 5 critically ill patients who underwent EEG monitoring. These findings highlight the importance of EEG monitoring in high-risk patients with COVID-19 and encephalopathy. EEG recordings in such patients can identify pathological patterns that will benefit from treatment with anti-seizure medications.”

Continuous EEG findings in patients with COVID19 infection admitted to a New York academic hospital system

“Our study supports growing evidence that COVID19 can affect the central nervous system, although seizures are unlikely a common cause of encephalopathy. Seizures and epileptiform activity on EEG occurred infrequently, and having a history of epilepsy or seizure(s) prior to EEG testing was predictive of epileptiform findings. This has important implications for triaging EEG testing in this population.

The prevalence of epileptiform findings on electroencephalography (EEG) among patients critically ill due to COVID19 is 30%.”