Abstract Details

Since the advent of the COVID-19 pandemic, anecdotal reports have indicated a possible relationship between COVID-19 infections and novel seizures.  We analyzed 534 patients who were admitted with COVID-19 infections and administered antiepileptic medications between 1 February and 30 June 2020 within a single health system in New York City and adjacent counties.

This study explores the relationship between the incidences of COVID-19 infections and novel or breakthrough epileptic seizures in the largest patient sample to date in a single New York-based hospital system.

Patients were included in this case control study if they were admitted to a hospital in the health system and had a confirmed positive test for COVID-19 infection during the admission. Only patients who were administered antiepileptic medications during the admission for any reason were included in this study. These patients were divided into those with and those without a known history of epilepsy. The incidences of new-onset seizures and mortality rates were compared between these groups using Pearson’s chi-squared test, and then statistical significance with Fisher’s exact test and odds ratios (OR) were calculated.

Novel seizures were more likely to occur in patients without a known history of epilepsy than in patients with one (p<0.0001, OR=2.65). Mortality rates were higher among patients who had a novel seizure than those who did not (p=0.0250, OR=1.70). There was no difference in mortality rates between patients who had a history of epilepsy and those who did not (p=0.6632).

These results reveal a higher incidence of new-onset seizures in patients without a known history of epilepsy than the incidence of breakthrough seizures in patients with a known history of epilepsy. This may indicate that new COVID-19 infections could cause novel seizures in patients without pre-existing epilepsy, and would warrant further exploration into the pathophysiology of this phenomenon.