key: cord-0742680-njfn99e6
authors: Santos de Lima, Fabiane; Klein, Sara; El Ammar, Faten; Wu, Shasha; Rose, Sandra; Tao, James X.; Issa, Naoum P.
title: Rapid development of seizures and PRES in a Covid-19 patient
date: 2021-03-04
journal: Epilepsy Behav Rep
DOI: 10.1016/j.ebr.2021.100436
sha: 84af52009d38b4bc5d64e55638f2bc16d8501bcf
doc_id: 742680
cord_uid: njfn99e6

Neurological dysfunction has been noted in up to 36% of patients hospitalized with COVID-19, and a variety of mechanisms of neurological injury are possible. Here we report the rapid development of PRES and acute seizures in a patient with COVID-19 infection and sickle cell disease. The combination of COVID and sickle cell disease may raise the risk of PRES and could contribute to the higher mortality rate of COVID in patients with sickle cell disease.

Neurological dysfunction has been noted in up to 36% of patients hospitalized with COVID- (Table) .

A second brain MRI four days after the first showed extensive areas of T2/FLAIR 64 hyperintensity in the bilateral cerebral hemispheres with mild scattered areas of sulcal 65 enhancement and superimposed gyriform restricted diffusion in the right temporo-occipito-67 resolved ( Figure 1B, C, D) . Another brain MRI three days later showed progression to nearly 68 confluent areas of T2/FLAIR hyperintensity in the right hemispheric white matter and to a lesser 69 extent in the left hemisphere. There was minimal residual diffusion restriction at the right 70 temporo-parietal occipital junction and no clear abnormal enhancement (Figure 1E, F, G, H, I) .

The patient's condition improved over the following four days to her prior baseline, with no 72 focal neurological deficits upon discharge. MRI four months later showed complete resolution of 73 the white matter changes. 

Neurologic Manifestations of Hospitalized Patients with 121

Coronavirus Disease

ILAE Official Report: A practical clinical 124 definition of epilepsy

Catrin Blank S. Posterior reversible encephalopathy syndrome: A 128 truly treatable neurologic illness

Posterior reversible encephalopathy syndrome 131 (PRES) as a neurological association in severe Covid-19

Posterior reversible encephalopathy syndrome in 134 patients with COVID-19

Brain imaging of patients with COVID-19: Findings at 136 an academic institution during the height of the Outbreak in New York City

Posterior Reversible Encephalopathy Syndrome in adult sickle-cell 139 patients: Case series and literature review

Sickle cell disease complications: Prevalence 142 and resource utilization

Coronavirus Disease among Persons with 144 Sickle Cell Disease

COVID-19, de novo seizures, 147 and epilepsy: a systematic review

Epileptiform activity and seizures in patients 149 with COVID-19

Meningitis/Encephalitis Panel* included Escherichia Coli K1, Haemophilus Influenzae, 158 Listeria Monocytogenes, Neisseria Menigitidis

Enterovirus, Herpes Simplex Virus 1 (HSV-1)

Human Herpes Virus 6 (HHV-6), Human Parechovirus, Varicella 161 Zoster Virus, Cryptococcus Neoformans/ Gattii. Encephalopathy-Autoimmune panel** 162 included AMPA-R Antibody CBA