Seizures and COVID-19: Results from the Spanish Society of Neurology’s COVID-19 registry

We describe a series of patients with COVID-19 who presented with seizures, reported in the Spanish Society of Neurology’s COVID-19 Registry. This observational, descriptive, multicentre, registry-based study includes patients with confirmed COVID-19 who experienced seizures during active infection. We describe the clinical presentation of COVID-19, seizures, and results of complementary tests. We also describe the suspected aetiology of the seizures. Of 232 reported cases, 26 (11.2%) presented with seizures; 7 of these patients (26.9%) had prior history of epilepsy, whereas the remaining 19 (73.1%) had no history of seizures. In most cases, seizures presented on days 0 and 7 after onset of COVID-19. By seizure type, 8 patients (30.7%) presented generalised tonic-clonic seizures, 7 (26.9%) status epilepticus, 8 (30.7%) focal impaired-awareness seizures, and 4 (11.7%) secondary generalised seizures. Six patients (23.1%) also presented other neurological symptoms, including altered mental status and decreased level of consciousness. Predisposing factors for seizures (eg, dementia, tumour, cerebrovascular disease) were observed in 10 of the 19 patients with no prior history of epilepsy (52.6%). Patients with COVID-19 may present with seizures over the course of the disease, either alone or in the context of encephalopathy. Seizures may present in patients with no prior history of epilepsy; however, most of these patients present predisposing factors.