Covid-19 Enfeksiyonuna Sekonder Konvülziyon Gelişen Çocuklarda Beyin MRG Bulguları
Year 2022,
Volume: 19 Issue: 3, 483 - 487, 27.12.2022
Ferit Doğan
,
Mehmet Zeki Yılmaztekin
Abstract
Amaç: Bu çalışmanın amacı, COVID-19 enfeksiyonu sonrası konvülziyon gelişen çocuklarda manyetik rezonans görüntüleme (MRG) bulgularını araştırmaktı.
Materyal ve Metod: Mart 2020 ile Haziran 2021 arasında COVID-19 pandemi kliniğine COVID-19 enfeksiyonu şüphesiyle başvuran ve pozitif gerçek zamanlı polimeraz zincir reaksiyonu testinden (qRT) COVID-19 tanısı alan pediatrik vakaların retrospektif taraması yapıldı. Konvülziyonlu tüm hastalara 3-Tesla cihazı kullanılarak kontrastsız beyin ve difüzyon MRG yapıldı. Konvülziyon gelişen COVID-19 enfeksiyonlu olguların demografik özellikleri ve beyin MRG bulguları kaydedildi.
Bulgular: COVID-19 tanısı konan ve hastalık seyri sırasında konvülziyon gelişen 6 olgunun değerlendirilmesi yapıldı. 3 hastada konvülziyon öyküsü vardı ve antikonvülzan tedaviye rağmen tekrarlayan konvülziyon atakları gelişti. Konvülziyon gelişen diğer 3 hastada konvülziyon öyküsü veya ek hastalık yoktu. Tüm hastalarda etiyoloji için kontrastsız beyin MRG çekildi. Tüm olguların difüzyon MRG'sinde akut patolojiye ait sinyal değişikliği saptanmadı.
Sonuç: COVID-19 enfeksiyonu epilepsili ve antikonvülzan tedavi alan hastalarda dahi konvülsiyonu tetikleyebilir ve önceden sağlıklı olan olgularda konvülziyona neden olabilir. Yetişkin hasta popülasyonundan farklı olarak, COVID-19 enfeksiyonuna bağlı konvülziyon gelişen pediatrik yaş grubunda COVID-19 enfeksiyonunun beyin MRG bulgularında akut değişikliklere neden olduğu görülmedi.
Supporting Institution
YOK
References
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- 2. Gumus H, Ozcan Y, Kazanasmaz H, Demir A, Guzelcicek A. Clinical Characteristics of COVID-19 Infection in the Pediatric Age Group. Electron J Gen Med. 202: 24;18(5):em308.
- 3. Lu L, Xiong W, Liu D, Liu J, Yang D, Li N, et al. New onset acute symptomatic seizure and risk factors in coronavi-rus disease 2019: A retrospective multicenter study. Epi-lepsia. 2020; 61(6):e49–53.
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- 7. Lüders H, Vaca GF-B, Akamatsu N, Amina S, Arzimanog-lou A, Baumgartner C, et al. Classification of paroxysmal events and the four-dimensional epilepsy classification system. Epileptic Disord. 2019; 21(1):1-29.
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- 14. Rajbhandari S, Rajbhandari S, Chandra A, Gurung P, Raj-bhandari P, Pant B, et al. Cerebral venous sinus throm-bosis as a complication of COVID-19 infection - A case report. Ann Med Surg. 2022; 74:103326.
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Brain MRI Findings In Children With Convulsions Secondary to Covid-19 Infection
Year 2022,
Volume: 19 Issue: 3, 483 - 487, 27.12.2022
Ferit Doğan
,
Mehmet Zeki Yılmaztekin
Abstract
Background: The aim of the current study was to investigate magnetic resonance imaging (MRI) findings in children who developed convulsions after COVID-19 infection.
Materials and Methods: A retrospective screening was made of paediatric cases who presented at the COVID-19 pandemic clinic with suspected COVID-19 infection between March 2020 and June 2021 and were diagnosed with COVID-19 from a positive real-time polymerase chain reaction test (qRT-PCR). Non-contrast brain and diffusion MRI performed using a 3-Tesla device in all patients with convulsions. The demographic characteristics and brain MRI findings were recorded of cases with COVID-19 infection who developed convulsions.
Results: Evaluation was made of 6 cases who were diagnosed with COVID-19 and developed convulsions during the disease course. There was a history of convulsions in 3 patients and recurrent convulsion attacks developed despite anticonvulsant therapy. In the other 3 cases developed convulsion, there was no history of convulsions, or additional disease. Non-contrast brain MRI was taken for etiology in all patients. In all the cases, no signal changes of acute pathologies were detected on diffusion MRI.
Conclusion: COVID-19 infection can trigger convulsions even in patients with epilepsy and taking anticonvulsant therapy and may cause convulsions in previously healthy cases. Unlike in the adult patient population, COVID-19 infection was not seen to cause acute changes in brain MRI findings in the pediatric age group who developed convulsions due to COVID-19 infection.
References
- 1. Rothan HA, Byrareddy SN. The epidemiology and pat-hogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020; 109:102433.
- 2. Gumus H, Ozcan Y, Kazanasmaz H, Demir A, Guzelcicek A. Clinical Characteristics of COVID-19 Infection in the Pediatric Age Group. Electron J Gen Med. 202: 24;18(5):em308.
- 3. Lu L, Xiong W, Liu D, Liu J, Yang D, Li N, et al. New onset acute symptomatic seizure and risk factors in coronavi-rus disease 2019: A retrospective multicenter study. Epi-lepsia. 2020; 61(6):e49–53.
- 4. Jayaraman K, Rangasami R, Chandrasekharan A. Magne-tic Resonance Imaging Findings in Viral Encephalitis: A Pictorial Essay. J Neurosci Rural Pract. 2018; 9(4):556–60.
- 5. Moriguchi T, Harii N, Goto J, Harada D, Sugawara H, Ta-kamino J, et al. A first case of meningitis/encephalitis associated with SARS-Coronavirus-2. Int J Infect Dis. 2020; 94:55–8.
- 6. Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia. 2014; 55(4):475–82.
- 7. Lüders H, Vaca GF-B, Akamatsu N, Amina S, Arzimanog-lou A, Baumgartner C, et al. Classification of paroxysmal events and the four-dimensional epilepsy classification system. Epileptic Disord. 2019; 21(1):1-29.
- 8. Asadi-Pooya AA. Seizures associated with coronavirus infections. Seizure. 2020 Jul; 79:49–52.
- 9. Asadi-Pooya AA, Simani L. Central nervous system ma-nifestations of COVID-19: A systematic review. J Neurol Sci. 2020; 413:116832.
- 10. Pons-Escoda A, Naval-Baudín P, Majós C, Camins A, Cardona P, Cos M, et al. Neurologic Involvement in COVID-19: Cause or Coincidence? A Neuroimaging Perspective. Am J Neuroradiol. 2020; 41(8):1365–9.
- 11. Efe IE, Aydin OU, Alabulut A, Celik O, Aydin K. COVID-19−Associated Encephalitis Mimicking Glial Tumor. World Neurosurg. 2020; 140:46–8.
- 12. Morassi M, Bagatto D, Cobelli M, D’Agostini S, Gigli GL, Bnà C, et al. Cerebrovascular complications in patients with SARS-CoV-2 infection: Case series. EuropaPMC. 2020;1–13. DOI: 10.21203/rs.3.rs-23137/v1
- 13. Poyiadji N, Shahin G, Noujaim D, Stone M, Patel SC, Griffith B. COVID-19-associated Acute Hemorrhagic Necrotizing Encephalopathy: Imaging Features. Radio-logy. 2020; 296(2):E119–20.
- 14. Rajbhandari S, Rajbhandari S, Chandra A, Gurung P, Raj-bhandari P, Pant B, et al. Cerebral venous sinus throm-bosis as a complication of COVID-19 infection - A case report. Ann Med Surg. 2022; 74:103326.
- 15. Sun D, Li H, Lu X-X, Xiao H, Ren J, Zhang FR, et al. Clinical features of severe pediatric patients with coronavirus disease 2019 in Wuhan: a single center’s observational study. World J Pediatr. 2020; 16(3):251–9.
- 16. McAbee GN, Brosgol Y, Pavlakis S, Agha R, Gaffoor M. Encephalitis Associated with COVID-19 Infection in an 11-Year-Old Child. Pediatr Neurol. 2020; 109:94.