New Onset Seizures Evolving into Refractory Status Epilepticus in the Setting of COVID-19: a Case Report

  The novel Coronavirus disease (COVID-19) has been shown to involve the nervous system (both central and peripheral), with or without respiratory involvement in multiple ways. Although not much is known about this disease yet, seizures and status epilepticus which may evolve into refractory status epilepticus have been associated with it along with other manifestations like encephalopathy, neuropathies etc. The mechanism for development of seizures with COVID-19 related disease is not entirely known however it can be the consequence of “cytokine release syndrome” or “cytokine storm” which has been associated with this virus. Patients with COVID-19 infection who develop resistant status epilepticus may have increased morbidity hence early recognition and starting appropriate therapy are key to avoid possible poor outcomes. Here, we present a case of a patient with new onset seizures that rapidly progressed to refractory status epilepticus in the context of COVID-19 infection. Our case report highlights the need of testing for systemic viral infections like SARS-CoV-2 in refractory status epilepticus and using therapies like corticosteroids and IVIG that have shown a role in COVID-19 induced seizures and encephalitis.