Coronavirus disease 2019 (COVID-19) has been described as being primarily responsible for respiratory symptoms. Although several case reports have shown the importance of neurological manifestations, only a few have reported non-convulsive status epilepticus (NCSE) as the first manifestation of COVID-19 infection. Here, we report the case of a 30-year-old male patient with no past medical history who was admitted with altered consciousness. On examination, the patient had a Glasgow Coma Scale (GCS) of 13/15. Vital signs were within normal range. Computed tomography scan of the and magnetic resonance imaging of the brain were normal. Biochemical assessments showed a mild hyponatremia (134 mEq/L) and high levels of D-dimer and lactate dehydrogenase. Urine drug screening did not find any abnormality and a lumbar puncture showed an increased cerebrospinal fluid protein. The result of the reverse transcription polymerase chain reaction test in the nasopharyngeal swab was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Electroencephalogram (EEG) showed a generalized epileptiform activity. Upon undergoing antiepileptic treatment, patient’s GCS improved to 15 gradually. A repeated EEG confirmed complete resolution of epileptic abnormalities four days later. This case report shows that SARS-CoV-2 infection can directly involve the central nervous system and can be manifested with isolated NCSE without any other neurological manifestations.
【저자키워드】 COVID-19, SARS-CoV-2, Seizure, status epilepticus, Confusion, 【초록키워드】 Treatment, Coronavirus disease 2019, coronavirus, magnetic resonance imaging, hyponatremia, SARS-COV-2 infection, D-dimer, tomography, Drug screening, lactate dehydrogenase, Brain, Case report, Nasopharyngeal swab, Protein, COVID-19 infection, male, Patient, Mild, neurological manifestations, vital sign, reverse transcription, Central nervous system, cerebrospinal fluid, scale, respiratory symptoms, acute respiratory syndrome, positive, abnormality, Complete, repeated, polymerase chain, shown, responsible, described, reported, the patient, manifested, epileptiform, 【제목키워드】 status, cause, Potential,