Seizures as the main presenting manifestation of acute SARS-CoV-2 infection in children. (November 2021)

• Record Type: Journal Article
• Authors: Kurd, Mohammad; Hashavya, Saar; Benenson, Shmuel; Gilboa, Tal
• Is Part Of: Seizure. Volume 92(2021)
• Page Start: 89
• Page End: 93
• Publication Date: 2021-11
• Subjects: Seizures -- Status epilepticus -- COVID-19 -- SARS-CoV-2; Epilepsy -- Periodicals; Epilepsy -- Periodicals; Seizures -- Periodicals; Épilepsie -- Périodiques; Electronic journals; Electronic journals; 616.853
• DOI: 10.1016/j.seizure.2021.08.017
• Languages: English
• ISSNs: 1059-1311

Abstract

Highlights: Pediatric COVID-19 may present with seizures, with or without fever, and no other influenza-like symptoms. Seizures in pediatric COVID-19 may occur in otherwise healthy children with mild SARS-CoV-2 infection. In areas where COVID-19 is spreading, testing children with seizures for COVID-19 may improve infection control. Summary: Objectives: To explore the rate, characteristics, risk factors, and prognosis of children presenting with seizures as the main symptom of acute COVID-19 (coronavirus disease 2019). Methods: We conducted a systematic retrospective study to identify all children who presented to the emergency departments of a tertiary academic medical center between March 1st and December 31st 2020 and had a SARS-CoV-2 infection based on RT-PCR (reverse transcription-polymerase chain reaction) from nasopharyngeal swab. Clinical and demographic data were extracted from the electronic medical records and reviewed. Results: Total of 175 children were diagnosed with acute SARS-CoV-2 infection in the emergency departments during the study period. Of those, 11 presented with seizures. Age ranged from six months to 17 years and 4 were girls. Five presented with status epilepticus and responded to loading doses of anti-seizure medications. Six had fever. Seven had prior history of neurological disorder. Full recovery was the rule. Significance: Unlike in adults, seizures occur early and may be the main manifestation of acute COVID-19 in children. Seizures, including status epilepticus, may occur without fever even in children with no history of epilepsy and are not associated with severe disease. A high index of suspicion is required for early diagnosis thus infection control measures can be taken.