Using a cross-sectional questionnaire study, our group examined the experience of patients with PNES at a single Comprehensi But that doesnt mean its okay to ignore guidelines wearing a mask, social distancing, frequently washing your hands. The peak HR in the whole cohort is at 23 days, similar to that seen in those older than 16 years. Neurological Events Reported after COVID-19 Vaccines: An Analysis of VAERS. 2022 Jul;139:106-113. doi: 10.1016/j.clinph.2022.05.003. 2022 Feb;127:108454. doi: 10.1016/j.yebeh.2021.108454. eCollection 2022. Psychogenic non-epileptic seizures (PNES) in the COVID-19 pandemic era: A systematic review with individual patients' analysis. Getting sick or having a fever, in general, can make seizures more frequent, however. and transmitted securely. Similarly, there were significantly increased risks in both seizures and epilepsy measured individually in the nonhospitalized group only (Figure 3). Pediatr Neurol. Go to Neurology.org/N for full disclosures. Fifty-four patients (78% female; mean age of 31.36 years [SD = 10.6]) were contacted and 15 (28%) reported increased frequency of PNES during the pandemic. One primary way the virus may trigger these seizures is related to how the virus enters the nervous system. This difference was more marked in people who were not hospitalized, highlighting the risk of epilepsy and seizures even in those with less severe infection. 2023 Healthline Media LLC. Bethesda, MD 20894, Web Policies Epilepsia. This guideline covers diagnosing and managing epilepsy in children, young people and adults in primary and secondary care, and referral to tertiary services. Syncope, Seizure May Precede Cardiac Arrest in Children, Young Adults . Cohorts included all patients who had the index event (COVID-19 or influenza) between January 20, 2020 (the date of the first recorded COVID-19 case in the United States), and May 31, 2021, and who were still alive at the end of follow-up (August 24, 2021). sharing sensitive information, make sure youre on a federal Unlike adults, some children may experience seizures as the main symptom of COVID-19.. Propensity score matching (performed within the TriNetX network) created cohorts with matched baseline characteristics.15 Propensity score 1:1 matching used a greedy nearest neighbor approach with a caliper distance of 0.1 pooled SDs of the logit of the propensity score. Research has shown that, among other things, delirium and risk of stroke are both possible symptoms that come with COVID-19 infections. VAERS-reported new-onset seizures following use of COVID-19 vaccinations as compared to influenza vaccinations. Cautious interpretation is therefore warranted. The proportional hazard assumption was tested using the generalized Schoenfeld approach. Seizures are sudden disturbances of electrical activity in your brain that can cause changes in consciousness, behavior, or movements. Methods: Those without neurologic manifestations often only had positive COVID-19 PCR results, suggestive of acute infection.20. Front Hum Neurosci. Statistical significance was set at 2-sided p values <0.05. 8600 Rockville Pike Currently, WHO-approved COVID-19 vaccines include RNA, adenovirus vector, and inactivated vaccines. MeSH Clin Case Rep. 2022 Oct 11;10(10):e6430. Cleveland Clinic 1995-2023. Larger dedicated studies of patients with PNES are needed to understand the impact of the pandemic's widespread societal effects on these patients. The shaded areas around the curves represent 95% CI. 2023 Epilepsy Foundation, is a non-profit organization with a 501(c)(3) tax-exempt status. Safety and Efficacy of Imatinib for Hospitalized Adults with COVID-19: A structured summary of a study protocol for a randomised controlled trial. Harrison were granted unrestricted access to the TriNetX Analytics network for the purposes of research and with no constraints on the analyses done or the decision to publish. Taquet M, et al. To date, the only reported post-infectious COVID-19 manifestations of neurologic disease include cognitive deficits and dysfunction of the peripheral nervous system. as well as what to write down before and after each seizure so you can capture every important detail. Epub 2022 Sep 23. Incidence of Epilepsy and Seizures Over the First 6 Months After a COVID-19 Diagnosis. Compared with influenza, there was an increased risk of the composite endpoint of seizures or epilepsy after COVID-19 in both children (1.34% vs 0.69%, HR 1.85, 95% CI 1.542.22, p < 0.0001) and adults (0.84% vs 0.54%, HR 1.56, 95% CI 1.371.77, p < 0.0001). Epub 2022 Sep 23. The virus seems to primarily trigger seizures through indirect means, such as increased levels of pro-inflammatory molecules in your brain. Understand how melatonin and alcohol interact and how best to take melatonin to avoid negative side effects. HHS Vulnerability Disclosure, Help We stratified data by age and by whether the person was hospitalized during the acute infection. Depending on the underlying cause and how you respond to medication, your doctor may also recommend: COVID-19 has been linked to many types of neurological complications including seizures. Significance: doi: 10.12659/AJCR.925786. Radiographic and electrographic data. How to Spot Epilepsy in Seniors When It Looks Like Dementia, When Your Childs Fever Leads to a Seizure: 8 Things to Do + When to Call 9-1-1, First Marijuana-Based Drug Approved for Treatment of Severe Forms of Epilepsy. The researchers concluded that the ability of the virus to induce epilepsy was likely very small. Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. In this cross-sectional study conducted during the second phase of the pandemic, adult patients with PNES documented by video-EEG and followed up in two tertiary epilepsy centers responded to a structured telephone survey. Seizures are an uncommon complication of COVID-19 and occur in fewer than 1% of people. However, hospitalization status was not a significant moderator (moderation coefficient 0.12, 95% CI 0.10 to 0.35, p = 0.28). eCollection 2022 Oct. Karakas C, Ward R, Hegazy M, Skrehot H, Haneef Z. Clin Neurophysiol. -, Nistic V., Goeta D., Gambini O., Demartini B. Using the TriNetX user interface, cohorts are created based on inclusion and exclusion criteria, matched for confounding variables, and compared for outcomes of interest over specified periods. Diagnostic and statistical manual of mental disorders: DSM-IV-TR. The COVID-19 outbreak and PNES: The impact of a ubiquitously felt stressor. As of October 2022, more than 622 million confirmed cases of COVID-19 have been reported worldwide. The risk of neurological complications after COVID-19 infection is up to 617 times higher than after COVID-19 vaccination. -, Kandemirli S.G., Dogan L., Sarikaya Z.T. 2021;117:107852. Unauthorized use of these marks is strictly prohibited. Seizures arent common in people with COVID-19, and a definitive association hasnt been made yet. The elevated risk among children was unexpected, although it is appreciated that COVID-19 affects adults and children differently.20,-,23 Pulmonary disease is the main manifestation in adults, while immune-mediated inflammatory response with or without multisystem inflammatory syndrome in children was the major manifestations of COVID-19 in children. Emadi A, Chua JV, Talwani R, Bentzen SM, Baddley J. Submissions should not have more than 5 authors. Careers. By the end of April 2022, there were 513 million COVID-19 cases worldwide with more than 6.23 million deaths.1 COVID-19 infection is associated with acute neurologic manifestations, particularly encephalopathy, agitation, confusion, anosmia, ageusia, and stroke.2,3 Compared with influenza, people who contract COVID-19 also show an increased risk of many neurologic and psychiatric sequelae in the subsequent 6 months, with incidence highest in those admitted to an intensive care setting.4 COVID-19 may impair neurologic function through effects on brain endothelial cells, inflammation, cytokine storm, and other mechanisms.5,6. The https:// ensures that you are connecting to the After regression, stress was the strongest predictor of PNES increased frequency. Submit only on articles published within 6 months of issue date. A nonepileptic seizure does not involve abnormal brain activity. In those younger than 16 years, the peak is delayed to 50 days and, at that point, the HR is nearly 3.0. Bookshelf This group will have guest speakers throughout the year to share the latest information about epilepsy and seizures. COVID-19 can have damaging effects on multiple organs in the body, including the brain. There is no definitive link between COVID-19 and seizures. In a March 2022 study from South Korea, researchers found that 6 out of 1,487 people hospitalized with COVID-19 developed new-onset seizures. We present a 71-year-old man with hypertension, diabetes mellitus, and COVID-19 diagnosed by RT-PCR who initially presented with posterior circulation stroke-like symptoms, which completely resolved after emergent thrombolysis. Rosengard JL, Ferastraoaru V, Donato J, Haut SR. Epilepsy Behav. Data presented in this article and the Supplement are freely accessed at osf.io/m8ht2. Neurol. The time of the peak HR is noted on the x-axis. This happens with other respiratory infections, too. Keywords: Frontera JA, et al. You can learn more about how we ensure our content is accurate and current by reading our. - DOI - PubMed Moriguchi T, Harii N, Goto J, et al. Unlike epileptic seizures, these episodes are caused by psychological factors (such as stress). There are intrinsic difficulties when coding for epilepsy and seizures. M. Taquet is an NIHR Academic Clinical Fellow and Oxford Health BRC Senior Research Fellow. -, Mao L., Jin H., Wang M. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. (2022). Disclaimer. Any characteristic with a standardized mean difference between cohorts lower than 0.1 is considered well matched.16 The Kaplan-Meier estimator was used to estimate the incidence of each outcome. Novel coronavirus SARS-CoV-2 has created unprecedented healthcare challenges. Epub 2021 Dec 14. Current research suggests that the SARS-CoV-2 virus doesnt seem to be highly neurotropic, but there are still several ways it may directly or indirectly lead to seizures. Bookshelf This site needs JavaScript to work properly. eCollection 2022. Six days later, the patient returned with seizure activity, supported by radiographic and electroencephalographic studies. 2020;78:7981. Separately, there was an increased risk of seizures (0.81% vs 0.51%, HR 1.55, 95% CI 1.391.74, p < 0.0001) and epilepsy (0.30% vs 0.17%, HR 1.87, 95% CI 1.542.28, p < 0.0001). The peak HR in these more susceptible groups occurred some weeks after infection with COVID-19, potentially suggesting an immune-mediated etiology. (2020). Clipboard, Search History, and several other advanced features are temporarily unavailable. The data did not allow this to be answered because of the limited number of patients with a sequential diagnosis of COVID-19, stroke, and subsequent epilepsy or seizures. It may sometimes cause side effects, especially if you misuse it. They provide data from uninsured and insured individuals. Many immune-mediated parainfectious CNS illnesses manifest sometime after the offending viral infection,24 consistent with the delayed peak in the risk of epilepsy in our COVID-19 pediatric cohort. 2021 Apr;117:107852. doi: 10.1016/j.yebeh.2021.107852. And its still important, especially if you have epilepsy, to keep up with your medications and healthcare appointments during the ongoing pandemic. Your last, or family, name, e.g. Encephale. Guidance. COVID-19 and Epilepsy. -, Herman C., Mayer K., Sarwal A. Scoping review of prevalence of neurologic comorbidities in patients hospitalized for COVID-19. Psychogenic nonepileptic seizures during the COVID-19 pandemic in New York City - A distinct response from the epilepsy experience. Wang C., Pan R., Wan X., Tan Y., Xu L., Ho C.S., et al. Valsamis H, Baki SA, Leung J, Ghosn S, Lapin B, Chari G, Rasheed IY, Park J, Punia V, Masri G, Nair D, Kaniecki AM, Edhi M, Saab CY. Letter to the editor. Neurological and psychiatric risk trajectories after SARS-CoV-2 infection: An analysis of 2-year retrospective cohort studies including 1 284 437 patients. ), NYU Grossman School of Medicine; UCL NIHR BRC Great Ormond Street Institute of Child Health (J.H.C. Transparent reporting of outcomes is crucial to better understanding how COVID-19 may interrelate with seizure disorders. Psychogenic non-epileptic seizures (PNES) in the COVID-19 pandemic era: A systematic review with individual patients' analysis. Washington, DC, American Psychiatric Association. The shaded areas around the curves represent 95% CI. government site. An official website of the United States government. COVID-19 and Seizures. Vohora D, et al. FOIA MeSH We matched a large number of people who had influenza to COVID-19 cases. Its a good idea to see a doctor if you have lingering symptoms for 4 weeks or more. Epub 2010 Jul 1. Careers. Please enable it to take advantage of the complete set of features! (2022). The researchers found that COVID-19 infection was not linked to an increased risk of epilepsy overall, but there was a moderately increased risk in people over 60. An official website of the United States government. Patients with COVID-19 who have no history of epilepsy may be at risk for novel seizures and subsequent adverse outcomes, including increased mortality. Patients with functional neurological disorders are vulnerable during ubiquitously felt stressors. PMC Taking Melatonin: Can You Mix Melatonin and Alcohol? government site. That the varying time of peak risk related to hospitalization and age may provide clues as to the underlying mechanisms of COVID-associated seizures and epilepsy. A randomized multicenter clinical trial to evaluate the efficacy of melatonin in the prophylaxis of SARS-CoV-2 infection in high-risk contacts (MeCOVID Trial): A structured summary of a study protocol for a randomised controlled trial. Before Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. contributors from the Global COVID-19 Neuro Research Coalition. 2020 Aug;69(8):1114-1123. doi: 10.1099/jmm.0.001231. The incidence of seizures within 6 months of COVID-19 was 0.81% (95% CI 0.750.88; HR compared with influenza 1.55 [1.391.74]). COVID-19 and Seizures. What types of seizures are possible after COVID-19 recovery? The .gov means its official. In a 2020 study, researchers identified seven people with COVID-19 who presented with seizures. 2020 May;130(5):522-532. doi: 10.1080/00207454.2019.1698566. Children with neurologic manifestations can be more likely to have positive COVID-19 antibodies either alone or in combination with COVID-19 PCR positivity. Cleveland Clinic is a non-profit academic medical center. ), St Pier's Lane, Dormansland, Lingfield, UK; and Oxford Epilepsy Research Group (A.S.), NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, UK. While the overall risk of seizures is therefore small,. Among our cohort of 18 subjects with PNES, 22.2% reported an improvement in seizure control during the peak of the COVID-19 pandemic in New York City. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology. -, Schuster M.A., Stein B.D., Jaycox L., Collins R.L., Marshall G.N., Elliott M.N., et al. Treatment for seizures depends on whether there is a known cause. 2022 Oct 15;11(3):46-54. eCollection 2022. We avoid using tertiary references. Exposure to terrorism, stress-related mental health symptoms, and coping behaviors among a nationally representative sample in Israel. 2011 Apr;37(2):153-8. doi: 10.1016/j.encep.2010.04.009. In those who do start medication, especially children, it will be crucial to track seizure profiles and long-term neurodevelopmental/neurocognitive outcomes. There are a few potential ways that the SARS-CoV-2 virus may trigger seizures. Some people have lingering COVID-19 symptoms for weeks or months after their infection. Weve seen that COVID-19 can cause events called cytokine storms where the virus causes the body to over-produce cytokine which can cause damage and inflammation in various organs. Compared to the cohort of subjects with epilepsy without PNES, subjects with PNES were significantly more likely to report an improvement (p = 0.033). and transmitted securely. Our Response to the COVID-19 Crisis. We cannot comment on people who were infected with COVID-19 but could not be matched to those from our influenza cohort. Its possible it causes a breakdown in the blood-brain barrier by producing too many cytokines, molecules that carry communication within and regulate our immune system. Although most of the COVID-19 and influenza cohorts were White, there was good representation of people of Black/African American and Hispanic heritage. Non-epilepsy patients vaccinated with inactive SARS-Cov . Federal government websites often end in .gov or .mil. Those were among 169 people admitted to the intensive care unit with severe or critical COVID-19 requiring intensive care and mechanical ventilation. Among individuals hospitalized with COVID-19 or influenza, the HR for seizures or epilepsy peaked at 9 vs 41 days in those who were not hospitalized. Can COVID-19 Cause Insomnia and Other Sleep Problems? We wanted to see if Cognitive Behaviour Therapy can help individuals with PNES and learning disabilities. government site. The risk of epilepsy was more marked in individuals younger than 16 years. These findings indicate that COVID-19 infection is associated with a higher risk of both epilepsy and seizures compared with influenza. PMC We closely matched people with COVID-19 infections to those with influenza. 2020 Jun 3;21(1):466. doi: 10.1186/s13063-020-04436-6. Notably, he was negative for SARS-CoV-2, and no other provoking factor was uncovered after a comprehensive work-up. Convulsions in children with COVID-19 during the Omicron wave. Vosburgh S, et al. In an October 2022 study from Sweden, researchers analyzed the risk of epilepsy in 1.2 million people with COVID-19 and an equal number of people in a control group. The views expressed are those of the authors and not necessarily those of the National Health Service, NIHR, or the Department of Health and Social Care. The left-most panel in each row is identical to facilitate comparison. Five of the people develop generalized tonic-clonic seizures. An increased probability of being diagnosed with seizures or epilepsy is observed in the 6 months after COVID-19 compared with after influenza. Does not increase the risk of getting COVID-19 AND Does not increase the severity of COVID-19 There is no evidence that people with epilepsy alone have a weakened immune system. Epub 2019 Aug 2. Kopaska M, Ochojska D, Mytych W, Lis MW, Bana-Zbczyk A. Sci Rep. 2022 Sep 1;12(1):14908. doi: 10.1038/s41598-022-19068-w. PLoS One. Acute symptomatic seizures have been reported in sporadic cases in patients with COVID-19.1 2 However, a recent large retrospective cohort study suggested that there was no increased risk of acute symptomatic seizures in these patients.3 As such, the association of seizures with COVID-19 has not been established. Managing Epilepsy During COVID-19 Crisis. The incidence of epilepsy was 0.30% (0.260.34; HR compared with influenza 1.87 [1.542.28]). I was diagnosed with epilepsy in 2012 after having what I now know to be focal impaired awareness seizures. Although the contrast between COVID-19 and influenza seems more marked among children (Figure 2), there was no significant moderation by age of this composite endpoint (moderation coefficient 0.20, 95% CI 0.025 to 0.42, p = 0.082). Among other neurological complications, experts are now studying a connection between COVID-19 and seizures. Patients with PNES showing symptoms of anxiety and depression are at higher risk of seizure worsening. Effects of a psychotherapeutic group intervention in patients with refractory mesial temporal lobe epilepsy and comorbid psychogenic nonepileptic seizures: A nonrandomized controlled study. It aims to improve diagnosis and treatment for different seizure types and epilepsy syndromes, and reduce the risks for people with epilepsy. doi: 10.1016/j.pediatrneurol.2014.07.011. Immune-mediated or inflammatory-mediated mechanisms of COVID-19 could contribute to epileptogenesis in the developing brain or unmask a previous predisposition to seizures. Ann Neurol. Neurological events reported after COVID-19 vaccines: An analysis of vaccine adverse event reporting system. Breakthrough seizures ater COVID-19 vaccines in patients with glioma (P4-9.005). But there have also been first-time seizures in people. Mechanisms, Effects, and Management of Neurological Complications of Post-Acute Sequelae of COVID-19 (NC-PASC). Personality traits, illness behaviors, and psychiatric comorbidity in individuals with psychogenic nonepileptic seizures (PNES), epilepsy, and other nonepileptic seizures (oNES): Differentiating between the conditions. Hospitalization status was a significant moderator for the association between COVID-19 and epilepsy (with the association being more marked among nonhospitalized patients; moderation coefficient 0.52, 95% CI 0.110.93, p = 0.012), but not for seizures (moderation coefficient 0.047, 95% CI 0.20 to 0.29, p = 0.70). The peak time for the HR was 21 days in adults and 50 days in children. A new study led by investigators at Massachusetts General Hospital (MGH) and Beth Israel Deaconess Medical Center (BIDMC) indicates that some hospitalized patients with COVID-19 experience nonconvulsive seizures, which may put them at a higher risk of dying. Major finding: About 5% of patients had complications during video-electroencephalographic monitoring, and about 90% of the patients were diagnosed on the basis of the results.Data source: A prospective study of 158 patients admitted during a 5-year period.Disclosures: The study was not funded. We do not know with which SARS-CoV-2 variant individual patients were infected, nor whether they had previously been vaccinated against SARS-CoV-2, and this might influence the likelihood of developing seizures. Gabapentin can help control seizures as well as nerve pain from shingles. official website and that any information you provide is encrypted According to the International League Against Epilepsy, research suggests that theres a low risk of seizures getting worse for most people with epilepsy. 2023 Epilepsy Foundation, is a non-profit organization with a 501(c)(3) . Seizures or convulsions have been reported in children with COVID-19, but they seem to be rare. Keywords: Chattopadhyay S, et al. sharing sensitive information, make sure youre on a federal Shawkat A, Merrell ET, Fadel GA, Amzuta I, Amin H, Shah AJ, Habeb H, Aiash H. Am J Case Rep. 2020 Jul 22;21:e925786. BRC-1215-20005. The observation of an increasing risk of seizures or epilepsy over a few weeks postCOVID-19 is, though, potentially consistent with an immune-mediated etiology. Reference 1 must be the article on which you are commenting. -, Rosengard J.L., Donato J., Ferastraoaru V., Zhao D., Molinero I., Boro A., et al. To capture these risk factors in patients' health records, 58 variables were used. New onset acute symptomatic seizure and risk factors in coronavirus disease 2019: a retrospective multicenter study, A first case of meningitis/encephalitis associated with SARS-Coronavirus-2, Epileptiform activity and seizures in patients with COVID-19, EEG findings in acutely ill patients investigated for SARS-CoV-2/COVID-19: a small case series preliminary report, Continuous EEG findings in patients with COVID-19 infection admitted to a New York academic hospital system, Epilepsy and COVID-19: updated evidence and narrative review, Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study, An introduction to propensity score methods for reducing the effects of confounding in observational studies, Flexible parametric proportional-hazards and proportional-odds models for censored survival data, with application to prognostic modelling and estimation of treatment effects, COVID-19, de novo seizures, and epilepsy: a systematic review, Neurological issues in children with COVID-19. Copyright 2021 Elsevier Inc. All rights reserved. FOIA COVID-19 and Epilepsy. If you have two or more seizures, you may have epilepsy. Shah T, et al. The primary outcome was the 6-month incidence of the composite endpoint of epilepsy (ICD-10 code G40) or seizures (ICD-10 code R56). about a 60 years-old male with an uneventful previous history who developed non-epileptic myoclonus status five days after a SARS-CoV-2 vaccination .He also tested positive for SARS-CoV-2 without showing any pulmonary or gastro-intestinal symptoms of the infection . The study used TriNetX Analytics, a federated network of linked electronic health records recording anonymized data from 59 healthcare organizations (HCOs), primarily in the United States, totaling 81 million patients. See this image and copyright information in PMC. Epub 2022 Dec 12. Of these, 0.25% of people had seizures. -, Valente K.D., Alessi R., Baroni G., Marin R., dos Santos B., Palmini A. Unable to load your collection due to an error, Unable to load your delegates due to an error. More details about the cohort definition including the ICD-10/CPT codes used are provided in the eMethods, links.lww.com/WNL/C480. Epilepsy has neurodevelopmental, psychological, social, and educational consequences.25,26 Although the infection is often mild in children, neurologic consequences of COVID-19 may potentially be more severe.27 Our data provide additional support for preventing COVID-19 infection in children, which can inform the risks-benefits balance of vaccination in pediatric populations. Severe psychological distress among patients with epilepsy during the COVID-19 outbreak in Southwest China. A few patients, particularly those with prior neurological issues, may experience occasional seizures. According to the researchers of a May 2022 study, COVID-19 vaccines may increase the likelihood of seizures due to the inflammation or sleep disruption that can follow vaccination. A: We already know there are a number of neurological complications that can be caused or complicated by COVID-19 and evidence now suggest that seizures could be another one of those issues. doi: 10.1001/jama.290.5.612. Unauthorized use of these marks is strictly prohibited. 'Royal Free Hospital'. Pathophysiology of COVID-19: why children fare better than adults? The comparison cohort was selected to be contemporaneous to the COVID-19 cohort to limit the effect of contextual factors (e.g., strained health services) on outcomes. Your organization or institution (if applicable), e.g. Int J Neurosci. Of the 859 patients, 217 (25.3%) had various non-epileptic adverse events, and none had severe non-epileptic adverse events. There are many different options for anti-seizure medicines. official website and that any information you provide is encrypted Keep reading to learn more about how COVID-19 may trigger seizures and whos at risk. 2014;51(5):619623. COVID-19 associates with psychological comorbidity, both in those with preexisting seizures33,-,35 and in those who do not have epilepsy.4 Although psychological stresses can contribute to the development of epilepsy, this can also precipitate psychological nonepileptic attacks (PNES, dissociative seizures, and functional seizures).36 PNES may be miscategorized as seizures or epilepsy, and this may be overrepresented in the COVID-19 cohort. DOI: https://doi.org/10.1212/WNL.0000000000201595, Kaplan-Meier Curves Comparing the 6-Month Cumulative Incidence of the Primary Outcome Between Matched Cohorts of Patients With COVID-19 vs Influenza, Kaplan-Meier Curves Comparing the 6-Month Cumulative Incidence of the Different Outcomes Between Matched Subgroups of Patients With COVID-19 vs Influenza, Kaplan-Meier Curves Comparing the 6-Month Cumulative Incidence of the Primary Outcome Between Matched Subgroups of Nonhospitalized and Hospitalized Patients With COVID-19 vs Influenza, Time-Varying Hazard Ratios for the Primary Analysis (Left) and Nonhospitalized/Hospitalized and Pediatric/Adult Subgroups, Neurologic features in severe SARS-CoV-2 infection, Emerging COVID-19 neurological manifestations: present outlook and potential neurological challenges in COVID-19 pandemic, 6-month neurological and psychiatric outcomes in 236 379 survivors of COVID-19: a retrospective cohort study using electronic health records, The SARS-CoV-2 main protease Mpro causes microvascular brain pathology by cleaving NEMO in brain endothelial cells, Neurological manifestations of COVID-19: a comprehensive literature review and discussion of mechanisms.
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