Seizures in the Setting of COVID-19

Purpose of reviewThis review presents current available data relating to seizures in the context of COVID-19 infection from theorized pathophysiology to presentations and treatments. We also review the impact the COVID-19 pandemic has had on people with epilepsy (PWE) with special consideration of changes in healthcare access and COVID-19 vaccine.Recent findingsPWE are not more susceptible to contracting COVID-19 infection; however, recent data suggests PWE are a potential high-risk population for more severe symptoms and ICU admission. Given drug-drug interactions, caution should be advised when using certain treatments for COVID-19 (i.e., antiviral medications) and anti-seizure medications (ASM). COVID-19 vaccines appear to be safe for PWE.SummaryAcute symptomatic seizures and status epilepticus are an infrequent but severe acute neurological sequelae of COVID-19 infection in patients with and without epilepsy. The COVID-19 pandemic has had an enormous impact on PWE, resulting in changes to the way we deliver healthcare, decreases in admissions to the epilepsy monitoring unit, and delays in surgical treatments for epilepsy. Further research is needed to better understand, if any, the long-term consequences of COVID-19 infection in PWE.

Automated summary

While individuals with epilepsy are not more likely to contract COVID-19, they may be at higher risk for severe symptoms and ICU admission. Caution is advised when using antiviral medications and anti-seizure medications due to potential drug interactions. COVID-19 vaccines appear to be safe for individuals with epilepsy.