A Rare Case of Increase in Seizure Frequency After COVID-19

Year 2023, , 115 - 118, 01.07.2023

Fatih Çatal , Murat Özsaraç , Onur Karakayalı , Yusuf Yürümez , Nuray Aslan

https://doi.org/10.38175/phnx.1196195

Abstract

Tuberous sclerosis complex (TSC) is a rare genetic disease and affected individuals are usually characterized by the triad of cutaneous angiofibroma, mental retardation and epileptic seizures. Different clinical tables may occur due to the inflammatory response after COVID19. Apart from this, there is no article in the literature reporting that the frequency of seizures has increased as stated in the case example presented. A 30-year-old male patient was brought to our emergency room by his relatives with the complaint of epileptic seizures. Relatives of the patients stated that the frequency of seizures increased progressively after having COVID19 a month ago and that he had seizures 10 times in the last 24 hours. As seen in the case we presented, there may be an increase in the frequency of seizures in the late period after COVID19 in patients with epilepsy. For this reason, patients with an increased seizure frequency by emergency medicine physicians should also be evaluated for COVID19.

Keywords

COVID19, complications, drug resistant epilepsy, tuberous sclerosis complex, epileptic seizure

Nadir Bir Olgu: COVID-19 Sonrası Nöbet Sıklığında Artış

Abstract

Tüberoskleroz Kompleksi (TSK) nadir görülen bir genetik hastalıktır ve etkilenen bireyler genellikle epileptik nöbetler, mental retardasyon ve kutanöz anjiyofibroma üçlüsü ile karakterize edilir. COVID19 sonrası inflamatuar yanıta bağlı olarak farklı klinik tablolar ortaya çıkabilir. Bunun dışında literatürde sunulan vaka örneğinde belirtildiği gibi nöbet sıklığının arttığını bildiren bir makale bulunmamaktadır. 30 yaşında erkek hasta epileptik nöbet şikayeti ile yakınları tarafından acil servisimize getirildi. Hasta yakınları, bir ay önce COVID19 geçirdikten sonra nöbet sıklığının giderek arttığını, son 24 saatte 10 kez nöbet geçirdiğini ifade etti. Bizim olgumuzda da görüldüğü gibi epilepsi tanılı hastalarda COVID19 sonrası geç dönemde nöbet sıklığında artış olabilir. Bu nedenle acil tıp hekimleri tarafından nöbet sıklığında artış tanımlayan hastaların COVID19’a yönelik de değerlendirilmesi gerekmektedir.

Keywords

COVID19, ilaca dirençli epilepsi, komplikasyonlar, tuberoskleroz kompleksi, epileptik nöbet

References

• Northrup H, Aronow ME, Bebin EM, Bissler J, Darling TN, de Vries PJ, et al. Updated International Tuberous Sclerosis Complex Diagnostic Criteria and Surveillance and Management Recommendations. Pediatr Neurol. 2021; 123: 50-66. DOI: 10.1016/j.pediatrneurol.2021.07.011.
• Seibert D, Hong CH, Takeuchi F, Olsen C, Hathaway O, Moss J, et al. Recognition of tuberous sclerosis in adult women: delayed presentation with life-threatening consequences. Ann Intern Med. 2011; 154(12): 806-813. DOI: 10.7326/0003-4819-154-12-201106210-00008.
• Zöllner JP, Franz DN, Hertzberg C, Nabbout R, Rosenow F, Sauter M, et al. A systematic review on the burden of illness in individuals with tuberous sclerosis complex (TSC). Orphanet J Rare Dis. 2020; 15(1): 23. DOI: 10.1186/s13023-019-1258-3.
• Nabbout R, Belousova E, Benedik MP, Carter T, Cottin V, Curatolo P, et al. Epilepsy in tuberous sclerosis complex: Findings from the TOSCA Study. Epilepsia Open. 2018; 4(1): 73-84. DOI: 10.1002/epi4.12286.
• Carroll E, Neumann N, Aguero-Rosenfeld ME, Lighter J, Czeisler BM, Melmed K, et al. Post–COVID-19 inflammatory syndrome manifesting as refractory status epilepticus. Epilepsia. 2020; 61(10): e135-e139. DOI: 10.1111/epi.16683.
• Salussolia CL, Klonowska K, Kwiatkowski DJ, Sahin M. Genetic Etiologies, Diagnosis, and Treatment of Tuberous Sclerosis Complex. Annu Rev Genomics Hum Genet. 2019; 20: 217-240. DOI: 10.1146/annurev-genom-083118-015354.
• Northrup H, Krueger DA. Tuberous sclerosis complex diagnostic criteria update: recommendations of the 2012 Iinternational Tuberous Sclerosis Complex Consensus Conference. Pediatr Neurol. 2013; 49(4): 243-254. DOI: 10.1016/j.pediatrneurol.2013.08.001.
• Miszewska D, Sugalska M, Józwiak S. Risk Factors Associated with Refractory Epilepsy in Patients with Tuberous Sclerosis Complex: A Systematic Review. J Clin Med. 2021; 10(23): 5495. DOI: 10.3390/jcm10235495.
• Curatolo P, Nabbout R, Lagae L, Aronica E, Ferreira JC, Feucht M, et al. Management of Epilepsy Associated with Tuberous Sclerosis Complex: Updated Clinical Recommendations. Eur J Paediatr Neurol. 2018; 22(5): 738-748. DOI: 10.1016/j.ejpn.2018.05.006.