Self-limited focal epilepsy in a young child with SARS-CoV-2: serendipity or causal association?

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Davide SilvagniPaolo Biban

Abstract

Neurological manifestations have been reported in adults with COVID-19. In children with COVID-19, data on neurological symptoms are scarce. A 4-year-old girl was assisted at home for prolonged afebrile seizures. She was unresponsive, with a conjugate eye right deviation lasting > 20 minutes. Intravenous midazolam was administered. Before arrival in our Emergency Department, EMS providers excluded risk factors for COVID-19, such as fever, respiratory symptoms, other signs of viral infections, or recent contacts with suspected COVID-19 cases. Upon her arrival, seizures had resolved, GCS was 12. Temperature was 36,6°C. Chest was clear (SatO2 100%). Blood tests did not show signs of infection. We collected a nasopharyngeal swab, which tested positive for SARS-CoV-2. The patient rapidly recovered her neurological function. A pediatric neurological examination and video-EEG recording produced a possible diagnosis of self-limited focal epilepsy, with temporo-occipital spikes. Family history revealed her father had occasional seizures during fever episodes, at 14 and 21 years. The child was discharged home, scheduling further neurological investigations once the swab was negative. Our case emphasizes that keeping a high suspicion f...Continue Reading

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