Characteristics of epileptic seizures in COVID-19 patients during the first year of the pandemic: a systematic review

Autores

  • Bruno Miceli Gonzalez Nogueira Federal University of the State of Rio de Janeiro, Biomedical Institute, Department of Morphological Sciences. Rio de Janeiro, Brazil. https://orcid.org/0000-0001-7931-3963
  • Cláudia Cecília da Silva Rêgo Federal University of the State of Rio de Janeiro, Biomedical Institute, Department of Morphological Sciences. Rio de Janeiro, Brazil. | Clementino Fraga Filho Teaching Hospital, Department of Neurology, Epilepsy Center. Rio de Janeiro, Brazil. https://orcid.org/0000-0002-1837-4401
  • Valéria Coelho Santa Rita Pereira Clementino Fraga Filho Teaching Hospital, Department of Neurology, Epilepsy Center. Rio de Janeiro, Brazil. https://orcid.org/0000-0002-7212-5043
  • Jorge Paes Barreto Marcondes de Souza Federal University of the State of Rio de Janeiro, Biomedical Institute, Department of Morphological Sciences. Rio de Janeiro, Brazil. | Clementino Fraga Filho Teaching Hospital, Department of Neurosurgery, Epilepsy Center. Rio de Janeiro, Brazil.
  • Soniza Vieira Alves-Leon Federal University of the State of Rio de Janeiro, Biomedical Institute, Department of Morphological Sciences. Rio de Janeiro, Brazil. | Clementino Fraga Filho Teaching Hospital, Department of Neurology, Epilepsy Center. Rio de Janeiro, Brazil. https://orcid.org/0000-0002-1538-6730

DOI:

https://doi.org/10.20453/rnp.v89i3.6835

Palavras-chave:

COVID-19, SARS-CoV-2, epileptic seizures, seizures, epilepsy

Resumo

In March 2020, the World Health Organization declared COVID-19 a pandemic. Epileptic seizures were described in different cohorts as being associated both with the acute phase and with long COVID-19. The objective of this review was to identify the incidence and characteristics of seizures in patients infected with SARS-CoV-2 in cohort studies published between December 2019 and December 2020. According to the PRISMA statement, a search in nine databases was conducted. One hundred and twenty-two articles were included in the final analysis. Of 9,285 patients, 328 (3.53%) adults and 22 (0.24%) pediatric patients had seizures during and/or after COVID-19. Of these, 71/328 (21.65%) adults and 5/22 (22.73%) pediatric patients had been diagnosed with epilepsy or had had an episode of seizure before infection. Among the classified seizures in adults, 14.33% (n = 47) were myoclonic, 14.02% (n = 46) generalized tonic-clonic seizures (GTCS) and 10.67% (n = 35) focal motor seizures. Of the pediatric patients, 10 (45.45%) had GTCS and 6 (27.27%) had status epilepticus with predominant motor symptoms. In 98.48% of the adults and in all 22 pediatric patients, the seizure occurred during the acute phase. The incidence of seizures was 3.6% in adults and 13.58% in pediatric patients. In adults, de novo seizures were approximately 3.1 times more incident than recrudescences; in pediatric patients, seizures in those without prior history were exactly three times more incident. Among the classified seizures, the most common was myoclonic in adults and GTCS in pediatric patients.

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Biografia do Autor

Bruno Miceli Gonzalez Nogueira, Federal University of the State of Rio de Janeiro, Biomedical Institute, Department of Morphological Sciences. Rio de Janeiro, Brazil.

     

Cláudia Cecília da Silva Rêgo, Federal University of the State of Rio de Janeiro, Biomedical Institute, Department of Morphological Sciences. Rio de Janeiro, Brazil. | Clementino Fraga Filho Teaching Hospital, Department of Neurology, Epilepsy Center. Rio de Janeiro, Brazil.

Graduated in Medicine from the Souza Marques School of Medicine. Medical Residency in Neurology at Santa Casa de Misericórdia do Rio de Janeiro. Postgraduate degree in Neurology from the Pontifical Catholic University of Rio de Janeiro. Neurologist, admitted to the State and Municipal Health Departments of Rio de Janeiro. Master's degree in Neurology from the Federal University of the State of Rio de Janeiro - UNIRIO (2011). PhD in Neurology from the Federal University of the State of Rio de Janeiro - UNIRIO (2016). Post-Doctorate (2020), within the scope of the project entitled "Characterization of Neurological, Immunological Phenotypes and Gene Polymorphisms with Immune Function in Zika Virus Infections, Chikungunya and Related Diseases", as part of the MCTIC / FNDCT-CNPq / MEC-CAPES / MS-Decit / N 14/2016 Call - Prevention and Combat of the Zika Virus, for 36 (thirty-six) months, with the concession starting in February 2017 and ending in January 2020. Coordinator of the Scientific Department of Epilepsy of the Brazilian Academy of Neurology, RJ Region, since January 2020, having been Vice-Coordinator from 2018 to 2019 and Secretary from 2015 to 2017. Currently a Physician at the Neurology Service / Epilepsy Program of the Clementino University Hospital Fraga Filho from the Federal University of Rio de Janeiro - HUCFF/UFRJ, where she works at the Epilepsy Center and participates in research projects on Drug-Resistant Epilepsy, Juvenile Myoclonic Epilepsy, Neurological Complications of Arboviruses and as a collaborating researcher in the project Accelerating Global Solutions for the Diagnosis and Treatment of Epilepsies (The AGENDA Study - Oxford Martin School), University of Oxford.

Valéria Coelho Santa Rita Pereira, Clementino Fraga Filho Teaching Hospital, Department of Neurology, Epilepsy Center. Rio de Janeiro, Brazil.

Graduated in Medicine from the Federal University of the State of Rio de Janeiro (UNIRIO, 1995). PhD in Neurology from the Federal University of Rio de Janeiro (UFRJ, 2018). Master's degree in Neurology from UFRJ, 2011. In addition to the area of Neurology, she has a Medical Residency in Adolescent Medicine from the State University of Rio de Janeiro (UERJ). She is a Physician in the Neurology Service of the Clementino Fraga Filho University Hospital (HUCFF) of UFRJ, working at the Epilepsy Treatment Center (CETEP) and the Unit of Idiopathic Inflammatory Demyelinating Diseases of the Central Nervous System. She is a Physician, Chief of Duty, at the Niterói Hospital Complex (CHN). She has experience in Neurology, with emphasis on Epilepsy, Electroencephalography, Multiple Sclerosis, and Cerebrovascular Diseases.

Jorge Paes Barreto Marcondes de Souza, Federal University of the State of Rio de Janeiro, Biomedical Institute, Department of Morphological Sciences. Rio de Janeiro, Brazil. | Clementino Fraga Filho Teaching Hospital, Department of Neurosurgery, Epilepsy Center. Rio de Janeiro, Brazil.

Adjunct Professor IV of the Department of Surgery of the Faculty of Medicine of the Federal University of Rio de Janeiro since 2000. Graduated in Medicine from the Federal University of Rio de Janeiro (1982), with a residency in Neurosurgery and subsequent Fellowship in Neurosurgery at the University of Chicago. Master's and PhD in Medicine from UFRJ (2000). Chief of the Neurosurgery Service at the UFRJ University Hospital from 1997 to 2017. Experience in Neurosurgery and Neuroscience focused on Cerebrovascular Disease, pituitary tumors, surgery and translational research in epilepsy, acting as neurosurgical coordinator and the creation of the first Treatment Center for Difficult-to-Control Epilepsy in the State of Rio de Janeiro, at the UFRJ University Hospital, linked to high complexity procedures at the Ministry of Health. Surgical experience in cerebral aneurysms and vascular malformations of the brain, as well as biological research in gliomas of the central nervous system and pituitary tumors. Principal Investigator and founder of the research line on clinical, genetic, and immunological biomarkers in the cerebrovascular disease known as cerebral cavernous malformation (CCM), responsible for the largest cohort in South America and the 4th largest in the world, monitored at HUCFF/UFRJ since 2000. He recently described novel mutations and biomarkers of inflammatory response in CCM, in close international partnership with the University of Chicago. This involvement includes leading research as a RATER of the MORE program at MaC Master University, as one of five neurosurgeons invited to establish a literature rating for the development of a recommendation panel for neurosurgeons. Scientific Director of the Institute for Research and Social Development Aliança Cavernoma Brasil in partnership with the Angioma Alliance of the States. He has published 71 articles in journals such as Nature Medicine, Nature Communications, Multiple Sclerosis Journal, Epilepsia Research, Scientific Report, Glia, Frontiers, Journal of Neurosurgery, among others, with 1869 citations, H index = 22 and i10 35 by Google Scholar, Web of Science ISI with 1231 citations, H index = 18 and Reseach Gate with a score of 33.21 and H index = 22. His commitment to human resources training led him to assume the Coordination of the Postgraduate Program in Surgical Sciences at UFRJ, in 2023, and scientific collaboration involving researchers from the University of Chicago, Oxford and other Brazilian universities.

Soniza Vieira Alves-Leon, Federal University of the State of Rio de Janeiro, Biomedical Institute, Department of Morphological Sciences. Rio de Janeiro, Brazil. | Clementino Fraga Filho Teaching Hospital, Department of Neurology, Epilepsy Center. Rio de Janeiro, Brazil.

Full Professor of Neurology at the Federal University of the State of Rio de Janeiro (UNIRIO), CNPq Research Productivity Fellow level 1B and Scientist of Our State by FAPERJ, where she was coordinator of the health area (2018-2024) and coordinates the research network in Precision Medicine in Neurodegenerative Diseases of the FAPERJ Call for Proposals on this theme. She created and heads the Translational Neuroscience Laboratory (LABNET) (Ordinance No. 596, of June 12, 2019 UNIRIO), registered on the multi-user platform of the Ministry of Science, Technology and Innovation (MCTI), with resources obtained through Calls from CAPES/CNPq, DECIT, FINEP, FAPERJ. LABNET develops next-generation sequencing (NGS) on the ION TORRENT Platform and researches plasma biomarkers on the SIMOA Platform (ultrasensitive single-molecule array technology) won in the FAPERJ Sediadas Public Notice since 2018, contributing to the advancement in translational neuroscience. During the last ten years, supported by a CNPq and FAPERJ scholarship, her research group has been substantially consolidating itself in the national and international scientific scene, advancing the understanding of the pathophysiological, immunological and genetic mechanisms of autoimmune diseases of the central nervous system, including those induced by viral triggers, identifying genetic characteristics and molecular mimicry between heterogeneous phenotypes, with more than 150 articles published at the head of the CNPq research directory in Neuroimmunogenetics in journals such as Nature Medicine, Nature Communications, Cell Reports, Multiple Sclerosis Journal, Epilepsia Research, Scientific Report, Glia, Frontiers, PlosOne, Viruses, Immunology, among others, with 23,552 views and 4,532 citations, H index = 31 and Hi173 by Google Scholar, Web of Science ISI with 3501 citations, H index = 31. She is a Professor of Neurology, with a Master's and PhD in Neurology from the Federal University of Rio de Janeiro. She is a Fellow of the Epilepsy Service at the Sainte-Anne Hospital of the University of Paris V, France (2004 and 2006), and founder of the Epilepsy Centers at HUCFF/UFRJ in 2000, registered with the Ministry of Health for high complexity care, and the Epilepsy Center at the Gafrée and Guinlle University Hospital of UNIRIO in 2013. She is an international partnership for biomarker research in cerebral cavernomas with the University of Chicago, and a scientific advisor to the Cavernoma Brazil Alliance. She is an international partnership with Stanford University for biomarker research for autoimmune encephalitis. She is an ad-hoc committee member for CAPES, CNPq, FAPERJ, and ANVISA. She is a reviewer for the following journals: Multiple Sclerosis and Related Disorders, Tissue Antigens, Journal of Neurological Science, Frontiers, Arquivos de Neuro-Psiquiatria, Clinical Neurology and Neurosurgery, Seizure, and the European Journal of Epilepsy, among others. She has been a Principal Investigator (PI) of Phase III Clinical Trials in Demyelinating Diseases and Epilepsies since 1995. In 2018, she completed a fellowship in Biomarker Updates at the Royal London Hospital, with theoretical and practical activities on the SIMOA platform. Her commitment to human resource development includes the completion and supervision of 90 Master's, Doctoral, and Postdoctoral students. Google Scholar Index hi 73.

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2026-09-25

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Nogueira BMG, Rêgo CC da S, Pereira VCSR, de Souza JPBM, Alves-Leon SV. Characteristics of epileptic seizures in COVID-19 patients during the first year of the pandemic: a systematic review. Rev Neuropsiquiatr [Internet]. 25º de setembro de 2026 [citado 3º de outubro de 2026];89(3):320-41. Disponível em: https://revistas.upch.edu.pe/index.php/RNP/article/view/6835

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v. 89 n. 3 (2026): Julio-septiembre

Seção

ARTÍCULO DE REVISIÓN

Licença

Copyright (c) 2026 Bruno Miceli Gonzalez Nogueira, Cláudia Cecília da Silva Rêgo, Valeria Coelho Santa Rita Pereira, Jorge Paes Barreto Marcondes de Souza, Soniza Vieira Alves-Leon

Creative Commons License

Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial 4.0 International License.